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Alexander's operation seems from the most recent experiences to be indicated only in those cases of backward displacement that are not complicated with adhesions and pelvic contraction. When the dis placement is due to morbid processes connected with the Fallopian tubes and ovaries the Alexander operation would be for the most part contraindicated. The operation can only be resorted to with advantage in cases of mere relaxation of tissue. In cases of adhesions it is plain that the contracted parts would draw upon the bladder. In uncomplicated cases the operation would insure the uterine fundus, being held over the bladder more in accordance with its normal relation than can be secured by a resort to the other surgical procedures. Speaking from my own experiences and observations I should say that the indications for Alexander's operation are extremely limited. The operation, though a delicate one, is often quite formidable and, unless
CLARKE AP. A CONSIDERATION OF THE VALUE OF THE ALEXANDER OPERATION COMPARED WITH THAT BY ANTERIOR FIXATION OF THE UTERUS. JAMA. 1896;XXVI(11):515–516. doi:10.1001/jama.1896.02430630017002e
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