Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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is no perineum. The anomaly is apersistence of the condition in Figure 236. If the anal sphincter isalso deficient, the condition is a pitiable one. When there is controlover the feces an operation may not absolutely be needed ; but whenthere is incontinence of feces it is always advisable, and preferably CONGENITAL MALFORMA TIOMS. 509 before maturity. Tlie usual operatiou lias been to pass a prol)e intothe fistula and out at the normal position of the anus, then split upthe parts, draw the reetuni downward and baekward to the angle ofthe ineision, suture it into position, and close the gap in front. Anioditication of this operation has been suggested by Buckniaster; inthis nioditication the new anus is made first just in front of the levatorani muscle, and at a later period the fibres of this muscle are split tomake a s))hiucter. Hypospadias in the female is a defect in the posterior wall of theurethra, or in extreme cases entire absence of the urethrovaginal Figure 243. Figure 244.
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FiGrEE 243.—Building of a urethra. Authors operation. Same as Figure 242. Margins ofnew urethral mucosa united over the sound hy fine continuous chromic catgut suture. Thefirst stitch has been introduced and tied, and the needle is being introduced for the secondstitch to unite the outer margins of the denuded area for the completion of the new urethra. Figure 244.—Building of a urethra. Authors operation. Same as Figure 243. Sound inposition as m Figures 242 and 243. Last stitch of a continuous suture being introduced. Thisstitch when tied will complete the formation of the new urethra. wall, with resulting incontinence of urine as in a vesicovaginal fistula.The malformation is a continuation of the foetal condition, shownin Figure 236, and it is due to persistence of the urogenitalsinus. The lower portion of the allantois has failed partially orcompletely at development into a urethra. In marked cases thereIS incontinence, but in slight cases there may be control of urine.Hypert

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