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Thus may have urethral with vesico-vaginal fistula cases d'Ormea, Torreo, Freund, Simon, Engelmann, or vesico-vaginal with vesico-uterine fistula or vesico-vaginal uterine with uretero-vaginal fistula case the author. There are also vesical, vaginal, and ureteral fistula where the Urethro-vaginal and vesico-vaginal fistula, with atresia a the urethra between tue two fistula?.

After Simon. vesico-vaginal wall injured at the spot where the ureter lies between vagina and bladder case Simon. Finally, double uretero-vaginal fistula may occur, as Freund We will now turn the causes and origin urinary fistulse. As a rule their origin quite clear. By far the greater part them are due malignant new growths the genitals see Introduction, page, and are not subjects for surgical treatment.

Of those which come under our care most are due certain puerperal processes. The origin, the seat, the whole process in the walls the affected organs are entirely different academic paper writing services in the other cases.

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may divide urinary fistulas into two great classes, puerperal and non-puerperal fistula?.

Puerperal urinary fistula? are such as stand in causal relation pregnancy, childbirth, or the puerperium. In these conditions the walls vagina and bladder are swollen and vascular, their vessels are much dilated, and the veins are often ectatic the union bladder and vagina more loose, and they are liable squeezed between any hard body and the margins the pelvis.

The causes which might work injury are also more active at this period, and affect custome essay larger areas surface. Thus the puerperal fistulas are sometimes enormous in size and the hyperasmic condition together with the irritation caused the lochial discharge, tend keep the ulcerative process.

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Puerperal urinary fistulas may urethro-, vesico-, uretero-vaginal and vesico-uterine fistulas. They may occur spontaneously or in consequence mechanical violence. The following causes have been noticed as originating spontaneous puerperal fistulas rupture the custom writing essay service cervix and the vesico vaginal septum when the head advances and the parts are rigid and cicatricial cases Berdot, Eiwisch, Detroit and others.

The literature this branch our subject has been collected Meissner and Duparcque-ISrevermann. Further noted are pressure effects when there are exostoses the pelvic wall, vesical calculi, and carcinomata the cervix and vagina. Then dissertation topics the necrosis gangrenous or diphtheritic parts, especially when there a narrow doctoral thesis writing pelvis, may occur. Simple necrosis during buy homework papers delivery of a woman with a narrow pelvis common in the other conditions is rare, partly because the patients usually die before can occur, and partly these processes most often affect the introitus vaginas and the posterior vaginal wall, and not disturb the essay writing services singapore bladder. The extent, the seat, and the time origin these fistulas vary greatly in accordance with the structure the tissue affected, the amount blood contains, its infiltration with serum, the length help me write a thesis time the pressure continued, and its intensity, and the nature the contusing body. the contusions caused the skull the infant in a small pelvis appear as round and striped academic writing service uk red patches, or as round, dry, colorless, gray, punched-out places. They are cast off process ulceration, and usually leave a circular loss tissue professional article writing services behind. The seat the injury varies in accordance with whether the contusion at the entrance the pelvis, or in the true pelvis. 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