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Easily digestible food and regular daily evacuation the bowels The removal the sutures done, as have said, the fourth the sixth day in the case silk, after the eighth day in the case of wire.

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Sore spots are cauterized do my term paper for me with the solid stick. Any little openings which may left can closed means caustic applications if this does not suffice, will necessary operate again This the mode procedure in urethro vaginal and vesico-vaginal fistula.

Some special additional precautions are, however, necessary for vesico-uterine and uretero vaginal fistulas.

In the superficial vesico-utero-vaginal fistulas the anterior lip the os uteri freshened and united the lower edge the fistula, which is formed research paper online help the vesical or possibly the free dissertation help urethro vaginal wall a whilst in the deep vesico-utero-vaginal the posterior lip the be united in the wound, thus making the woman sterile. Recently, however, Hegar has several times succeeded in curing longitudinal fistula with the help very small remains the anterior cervical wall.

As Martin and Schroder remark, vesico-uterine fistulae show a great tendency spontaneous cure, though operative buy essay online interference may necessary when they have existed for term paper service a long time.

In vesico-uterine fistula?, when cannot, after dilating the cervix, close the vesical opening energetic cauterization see successful cases Hildebrandt and Kaltenbach, must split i need help writing a thesis statement the cervix bilaterally, and bring the fistula into eyesight dragging down the anterior lip of the womb. The edges the fistula are then excised, and the cut surfaces united suture.

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Wilms has told himself that did this operation successfully long ago a number times.

Martin, Lossen, Miiller Oldenburg and many others, have done and I have cured five patients in this manner, see below.

In two my cases closure was not complete immediately after removing the sutures but soon ensued.

In first case I used silk, and I was unable to remove all the sutures, which had sunken deep into the uterine tissue.

Several months later four them encrusted with calcareous salts were evacuated the urethra. If direct union fails, nothing remains but to freshen both lips the womb and unite them essay writers canada together, performing hysterokleisis, first performed Jobert. L. Landau has recently proposed in cases uretero vaginal fistulae to pass a long elastic catheter from the vagina into the upper end the urethra, and then pass the lower end out through bladder and urethra. Then the patient placed in the knee-elbow position, and then the uncovered portion the catheter covered with the vaginal mucous membrane and the lower ureteral wall. The catheter remain in situ for some time. If this does not succeed a long oval piece be excised from the vesical and vaginal wall, and the direct uretero vaginal fistula thus changed into an ordinary help write an essay vesico-vaginal fistula, into the uppermost point which the ureter opens. Then the vesico-vaginal fistula closed deep sutures which pass through the vesical Simon, however, college scholarship essay help was led his want success in his early attempts secure direct and indirect healing uretero-vaginal fistulas teach in later years as follows the vesical wall pierced at the place of the fistula a sound passed from the bladder into the ureteral opening and the uretero-vesical wall then slit from the vesical surface for a distance an inch. The edges the are to daily separated with a large sound until cicatrization has set how to write dissertation proposal The vaginal fistula now lies at a distance from the new ureteral opening, and its edges can freshened and united. A small portion the adjacent vaginal vault could denuded, and used help the closure the fistula. Simon regarded this proceeding as more certain than that of Very recently Bandl operates as follows uretero vaginal fistulas. 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