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March 3, 1945


Author Affiliations


From the Department of Gynecology, Johns Hopkins University and Hospital.

JAMA. 1945;127(9):495-502. doi:10.1001/jama.1945.02860090001001

There is no subject in gynecology which can evoke more discussion among gynecologists than the treatment of uterine prolapse. In several clinics in this country vaginal panhysterectomy is done almost routinely to cure this condition; in others the Watkins interposition operation is the standard treatment, in others the Manchester operation is done and in still others extensive vaginal plastic work is combined with some type of intra-abdominal suspension. In general there has been a trend in the past two decades toward doing the entire procedure by the vaginal route unless intrapelvic disease necessitates laparotomy. It is my opinion that one should not approach the subject with a fixed plan of operation. Each case should be judged and treated as an individual problem. In selecting the best operative procedure in an individual case several factors must be taken into consideration. The most important of these factors are:

The general physical condition

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