On the treatment of uterine myomata (fibroids) / by J. Bland Sutton.

  • Bland-Sutton, John, Sir, 1855-1936.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of uterine myomata (fibroids) / by J. Bland Sutton. Source: Wellcome Collection.

    54/110 (page 46)
    Vaginal Myomectomy and Enucleation. The steps of this operation vary considerably as they depend upon the size, condition, and position of the tumour, but the preUminary preparation of the patient is the same in all cases, and consists of thorough evacuation of the bowels by purgatives aided by soap and water enemata; careful anti- septic douching of the vagina during two or three days preceding the operation. Mild solutions of perchloride of mercury (i in 5000) or tepid water lightly tinted with permanganate of potash answer very well for this purpose, as they are colourless, odourless, and thoroughly reliable antiseptic re- agents. The patient is anaesthetised and secured by the crutch in the lithotomy position and placed in a good light. The operator then exposes the cervix by means of a duck-bill speculum and thoroughly douches the vagina. The first step is to determine whether he has to deal with a tumour of the uterus or the fundus of a partially inverted uterus, and he should remember that a submucous myoma (polypus) sometimes leads to inversion (Fig. 14), and a myoma protruding at the os strikingly resembles an inverted fundus. The uncertainty is dispelled in this way. In a case of polypus, when the sound is introduced into the uterus, it will pass to the full length (2^ in.—6'2 cm.), more often to a greater distance. In a case of inversion the sound passes between the uterine wall and the inverted