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March 21, 1908


JAMA. 1908;L(12):963. doi:10.1001/jama.1908.25310380035004c

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History.  —Mrs. X. for twelve years had what she termed "falling of the womb." For the past four years, especially when on her feet, there was complete eversion of the vagina and prolapse of the uterus and intestines, the whole mass being the size of a child's head. The uterus was very much enlarged, being in a condition of hyperplasia. Various supports had been tried without relief, the condition being a source of great discomfort to her. A radical operation, as well as a choice of route, was obvious. Vaginal hysterectomy was the operation elected.

Operation.  —In operating in such a condition of enormous prolapse, the one difficulty naturally met with is ascertaining the line of reflection of the bladder from the cervix. The operation as performed was as follows: A curved incision was made through the vaginal wall, taking care not to injure any intestine which was included in

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