Sterility in woman : causes, treatment, and illustrative cases / by Mary A. Dixon Jones.

  • Jones, Mary Amanda Dixon, 1828-1908.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Sterility in woman : causes, treatment, and illustrative cases / by Mary A. Dixon Jones. 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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    fully and properly performed, it does good in many ways and helps to secure favorable results in several other operations, as in curetting, trachelorrhaphy, etc. I have diluted the cervix near three hundred times, and in no instance have I had an untoward result, or even a rise of temperature. But I have been led to query if, after all, “stenosis of the os” is in itself a cause of sterility. I have seen women with a markedly small os, who have borne children, and in a few instances, the os has remained small and virgin-like after several parturitions. Yet a contracted os is more easily obstructed ; so dilating, or removing any impediments or obstacles, will make conditions more favorable for conception. Even an accidental plug of mucus may block the passage, as we know that simply passing the sound has in some instances removed a temporary sterility. In like manner, polypoid growths in the cervix may effect- ually close the canal and be a cause of infertility. One patient had been married eight years and was sterile; I removed from the cervix two small pedunculated mucoid tumors, in ten months thereafter she gave birth to a child. That stenosis is at least unfavorable Tor concep- tion is proved by the fact that many women who have been sterile for years have, after dilating.the cervix, borne several children in quick succession. II. Flexions of the Uterus.—Anteflexion of the body or of the cervix is frequently found associated with stenosis and with an elon- gated cervix. For the anteflexion, posterior section with anterior in- cision has effected most remarkable results. It corrects in a degree the deformity, straightens the curve, renders the canal patulous, and thus in many instances the difficulty has been removed. One of the first patients for whom I performed this operation was Mrs. W , who consulted me in 1876 for sterility. The cervix was acutely anteflexed, and there was stenosis of both the external and internal os. I made posterior section and anterior incision, under lull aseptic precautions, put in the intra-uterine glass stem, tamponed for three days, then introduced the cup-shaped pessary. The patient recovered without a bad symptom, became pregnant a short while after, and in due time I delivered her of a well-formed, vigorous child, and there was no laceration of the cervix. Some have thought that patients who have had stenosis were more liable to cervix lacerations. But stenosis of the os, when not the out- come of disease, or caustic treatment, is not a cause of, nor does it pre- dispose to, lacerations of the cervix. I have demonstrated by micro- scopical examination that lacerations occur in those cases where a previous inflammation has transformed portions of smooth muscle-liber into fibrous connective tissue, which can not expand, and consequently, i