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This gave great relief, but only for a time new retention pains appeared at the old place, and an abundant purulent genital flow set Often they will tell that considerable quantities thin foul-smelling pus have been voided from time time, their great temporary relief.
The evacuation the hsematometra not always spontaneous but the conditions incomplete drainage also occurred in cases where puncture In a single case unilateral retention, and one in which hydrometra lateralis was present, there was an entire absence any history a previous hasmatometra. In every case examination reveals a tumor beside the uterus filled with fluid, which projects persuasive essay help more or less deeply into the vaginal lumen in accordance with the height the occluding septum. Often the vaginal portion the tumor projects forward and several times the closed half the genital canal has been seen applied in spiral fashion the open half. Fluctuation can felt between the upper and the lower portions the tumor.
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If the vaginal portions are unseparated, the uteri, as remarks, will take a lateral position as regards the tumor, forming an elongated, crescentic opening with its concavity directed the occluded side. If the tension the tumor's contents not too great, the vaginal portion the tumor will recognized as being softer need help with writing essay than the vaginal portion the uterus. Often, as I have recently seen renewed proof of in the case Johannowsky has described, can distinctly appreciate variations in the tension the vaginal tumor, clue contractions the sac. After the sac opened the smooth vaginal portion may distinguished from the uterus the ring-shaped When the mucous membrane of the exposed sac scraped with a curette, can sometimes get epithelium characteristic vagina or how to buy essay online uterus.
This I succeeded in demonstrating in two cases in which there was only a short rudiment the vagina present. The diagnosis will probably easiest in those cases in which the unilateral atresia at the vaginal entrance, and in which the cylindrical tumor runs the whole length the vagina. It will especially easy when, as in Simon's case, the bloody contents the tumor can be seen through the transparent sac-wall. Pyometra and pyokolpos will give a tumor with the same situation and characteristics and pressure upon the vaginal tumor will cause puc appear freely in the vagina from the if spontaneous perforatio sept, has occurred, and from the puncture or incision if there has been an As Schroder has shown, the differential diagnosis unilateral atresia chiefly with hematocele periuterina before our more exact clinical knowledge to-day more than one case atresia has been confounded with the section hematocele. Besides the history, the shape and the location the tumor, the characters thesis abstracts online described in the foregoing sections ought suffice for diagnosis. In high-seated atresias, forming a broad flat tumor, not impossible mistake the affection for a cystic tumor the ovary or tube attached the uterus or true pelvis or even, as I myself once saw, with a large laterally-seated soft myoma.
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In this last case an exploratory puncture will decide the matter.
The treatment congenital vaginal atresia only becomes a necessity after puberty has set in, except in those rare cases where the collection of catarrhal secretion within the sac necessitates surgical interference in childhood. Most authorities have rightly held that the demonstration of a blood-retention tumor a sine qua non for the operation since only when this made can certain the dilatation the atresia and decide upon the direction the incision.
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We are then sure also the existence a uterine cavity above the atresia. These considerations are the greatest importance. It would very desirable, if were possible, prevent the difficulties and dangers the condition a prophylactic operation. At present can only attempt in cases atresia hymenal The closed hymen can recognized without any great proquest dissertations search accumulation fluid behind can drawn down with sharp hooks and then incised. But even in these cases the differentiation the condition from other deep-seated atresias may rendered difficult excessive firmness and thickness the membrane in the adult, amenorrhoea present, that retentio mensium does not occur, repeated attempts at coitus may invaginate and displace as render its recognition almost impossible. Seyfert demonstrated a case the latter kind in my presence. But as a rule, there no question as the time for interference.
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