Perineorrhaphy, with special reference to its benefits in slight lacerations : and a description of a new mode of operating / by Edward W. Jenks.

  • Jenks, Edward W. (Edward Watrous), 1833-1903.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Perineorrhaphy, with special reference to its benefits in slight lacerations : and a description of a new mode of operating / by Edward W. Jenks. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In the following paper, the subject of perineorrhaphy or perineoplasty will be but in part considered, the object being more particularly to direct attention, first, to the incal- culable benefit which may be obtained from proper plastic operations within the vagina in a class of lacerations which have as a rule been considered as so slight and insignificant as not to be productive of any evil consequences. Second, the description of an operation in which the parts can be more easily and effectually denuded than has been customary, together with other procedures which help to simplify the operation. Among the many accidents incident to child-birth is laceration, more or less extensive, of the perineal region of the vagina, which differs in degree from a simple tearing of the fourchette to complete laceration of the perineum. The latter accident, if not immediately recognized by the accoucheur, is sure to be afterwards by the patient. The lacerations occurring between the two extremes just mentioned remain not unfre- quently undiscovered during a period of years, and in the mean time patients suffer from the many accompaniments of uterine disorders occasioned by the lack of proper support to the uterus, its retarded involution, and the dislocation, to a greater or lesser extent, of all the pelvic organs. It is not my purpose to discuss the prophylaxis of laceration of the perineum, nor to dwell at any length upon the primary operation for either complete or incomplete laceration. I cannot, however, forbear adding a word concerning the primary operation, the success or failure of which depending, as it does, upon causes not unfrequently overlooked. For instance, we find many advocating, in all cases of laceration, that the parts be brought together by sutures as soon after the delivery of the child as possible. Others seem to hold the primary operation in low esteem, as success does not always follow the immediate apposition of the parts, for it sometimes happens that, in spite of careful stitching and attention to every precaution, union does not take place, and upon removal of the sutures, the lacerated perineum yawns as much as if nothing had been done. The explanation of this is, I believe, easily made. In cases of labor where there has been much delay, or much manipulation within the parturient canal with the hands alone, or long con-