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But the loosening the bladder and urethra from the uterus and vagina, with depression the anterior peritoneal pocket, as has been represented in some the drawings, does not appear exist at all rather the septum urethro-vaginale under all circumstances forms the boundary which the anterior vaginal wall may separated from the bladder. Hiiffel's excellent drawing a section the pelvis with prolapsus incompl. without any change position the urinary bladder, shows how the separation the prolapsed anterior vaginal wall from the bladder limited anatomically its intimate connection with the layers the urethrovaginal septum.

It shows also a relatively firm vesical attachment, the peritoneal covering the organ lying above the upper college term paper writing service edge the symphysis, and the ligamenta vesicalia being tense. On the other hand phd thesis writing help the connective-tissue union between the portio supra vaginalis colli uteri, the upper part the anterior vaginal wall, and the bladder, appears be unusually loose and stretched into a thin stratum.

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Had the bladder been depicted empty, all the conditions necessary originate a hernia vaginalis anterior, might have been demonstrated in this drawing. Since a congenital depression theexcav.

ves. has not been noticed, and since in the few cases the affection which have been recorded, there has always been the complication prolapsus uteri totalis or partialis The older authorities.

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Meissner.

include cystocele vaginalis also in this designation.

The rarity this form the malady, and have help writing scholarship essays never seen a single case, shown the fact that not mentioned essay writer online in the text books pathological anatomy Rokitansky, Forster, Klob, Klebs and others. The most stoking, as well as the best described case that Martin which both Huff and Hegar and Kaltenbach have phd thesis paper copied.

But must object that the drawing, which shows a complete division the connection between the anterior vaginal wall and the bladder from the sinking the anterior peritoneal pocket, and extending almost through the entire urethro-vaginal septum, not in accord with write my dissertation Cohnheim's record the autopsy.

Cohnheim expressly says that the anterior vaginal wall, together help with paper with the urethra, was for an inch buy a psychology research paper in length in its normal position behind the pubis whilst the portion above that was markedly lengthened, statement of purpose writing i need someone to write my college essay service thickened and present, must regard hernia vaginalis anterior as an acquired dislocation.

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For its development the urinary bladder must firmly attached the anterior abdominal wall, and there must an unusually loose connective-tissue layer between the supra-vaginal portion the collum uteri and the bladder, and between the anterior vaginal wall and the bladder and finally the excav. vesico-uterina must abnormally broad from reclination the body the womb, and must also drawn down by the prolapsus colli uteri. When these conditions are present, the intraabdominal pressure upon writing dissertation proposal the excav. ante-uterina the one hand, and the tension the prolapsus upon the other, may able cause dislocation and separation the layers the septum vesico-vaginale in a degree such as Martin has described. The anatomical disposition in question Section through the Pelvis with Incomplete Prolapsus Uteri. After Hiiffel. most intimately connected with the etiology prolapsus uteri and we can only look upon hernia vag. ant. as one its consequences. We cannot recognize its primary occurrence from the cases thus far described.