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The course acquired atresia differs from that the congenital form, only in that the symptoms, being dependent upon some especial etiological moment, not necessarily begin at puberty, and that they are not infrequently accompanied write my paragraph for me other pathological appearances, due the same cause. Thus find puerperal vaginal obliterations comparatively frequently with vesical fistula?, and syphilitic stenosis with chronic ulceration, stenosis, and fistula the rectum. For the help with writing a research paper rest, their course the same as that congenital occlusions the menstrual blood accumulates above the atresia, if the same causes which have led the atresia have not caused amenhorrhoea also. The treatment does not differ from that congenital atresias and stenoses. But there one difficulty which often makes our task a very thankless one.

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That that the ulcerative processes which are at the base the malady frequently cause extensive and firm cicatricial adhesions the vagina, with partial destruction, help in writing an essay approximation, and fixation neighboring structures. Thus, besides the frequent complication with fistula? which have already mentioned, there often a loss tissue of the portio data analysis coursework vag.

in puerperal atresias. Nevertheless have the records not a few cases complete cure.

One the most interesting them, Dieffenbach, may mentioned here. A lady whose vagina had become completely closed in consequence injuries help in writing an essay received in childbed, permitted a physician attempt reestablish the passage.

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But the doctor, instead reopening the vagina, made his way into the bladder thus adding a large vesico-vaginal fistula at the introitus her atresia. Another physician sought make his way the uterus more posteriorly, and get into the rectum.

The latter false passage, however, closed itself. Dieffenbach succeeded in opening the vagina a most difficult operation and kept open by nsing bougies gradually increasing sizes for a long time.

The vesical fistula, large enough admit a finger, was not cured, editing dissertation as the patient became disgusted after an unsuccessful attempt close had been made. On account the difficulties which the dense cicatricial masses accompanying large fistulas add the operation for haematometra, Kleinwachter prefers follow Hegar's proposal, and leave unopened, and prevents further menstruation castration. Acute sepsis caused a fatal termination in the case operated upon. If the atresia occurs please help me write my essay during gravidity, and a broad one, as occurred in the cases which Levy, Lombard, and others have recorded, may form an irremovable obstacle spontaneous or even artificial delivery per vias naturales. In these cases the Cesarean section indicated, though under conditions which render the prognosis the worst for the mother, since the free outflow the lochia interfered with. It has never yet been successfully done the old methods. Porro's operation the only one available, as admitted even those who would restrict the indications for in favor the simple sectio Caesarea. Acquired vaginal stenoses are seen much more frequently than are complete closures. If a broad extent vaginal surface involved, treatment offers hardly fewer difficulties than in the class cases have just been considering. Such the tendency the stenosed cicatricial tissue to contract that the results dilatation are but temporary in the majority cases.

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