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Falling of the Womb - Prolapsus - Prolapse.Symptoms. - It is a singular fact that the unnatural sensation which accompanies a falling of the womb, does not bear any direct and constant relation to the amount of displacement of this organ ; there are instances in which the womb descends to the orifice of the vagina or even protrudes from that orifice without exciting marked discomfort in the patient. On the other hand, most severe and annoying symptoms are sometimes experienced for which no other possible cause can be discovered than a slight prolapsus, and which disappear so soon as this prolapsus is remedied. In most cases in which the womb has been forced but a little from its natural position, there will be observed pain in the back and loins, a sense of weight in the pelvis, leucorrhcea, inability for physical exertion, pain and difficulty in evacuating the bowels and bladder. It is a little remarkable that this particular displacement of the womb is not usually accompanied by derangement of menstruation - a point which is of value in distinguishing a simple prolapsus from the other displacements, versions and flexions which are usually so accompanied. A simple prolapsus moreover does not seem to cause sterility, while this condition is often associated with other displacements of the womb. The course of this affection varies extremely, as has been already indicated, though all cases of it agree in one respect, that there is no tendency to spontaneous recovery. The patient's health and comfort are impaired, her ability and disposition for exertion diminished ; but the disease itself has no tendency to induce a fatal result, unless indeed it be complicated by some of the other affections which so often follow in its trail. Treatment. - The treatment of prolapsus comprises two essential features: First, the removal of the cause, if such cause can be ascertained ; second, the replacement of the womb in its natural position. Under the former head must be included measures for preventing constipation, for removing the weight of clothing from the hips, and for obviating pressure upon the abdomen. If the patient be especially fleshy and have borne several children, benefit may usually be secured from the use of an abdominal supporter also. This part of the treatment may, therefore, consist in a regulation of the diet and the use of such medicines as will secure the daily evacuation of the bowels ; in the use of a corset suspended from the shoulders ; and in the employment of a bandage which may be buckled around the hips so as to support the abdominal wall. In addition to this, measures of especial caution should be taken during every menstrual period, since at this time the womb is heavier than in the intervals. These measures may consist in rest and the recumbent posture. The result of these efforts will be not to restore the womb to its proper position, but simply to remove the obstacles in the way of such restoration by means applied directly to the womb itself. First among these come injections with astringent remedies - that is, tannin, alum or oak bark. These may be reinforced by cool hip-baths and vaginal douches. The improvement of the general health will also favor success in the restoration of the womb. It is possible that these measures, when faithfully and conscientiously applied, may in certain mild cases effect the desired result. Yet, in the majority of instances, it will be necessary to employ in addition local mechanical means in order to restore the womb to its proper position and maintain it in that oosition. These means consist in instruments constructed for the purpose and known as pessaries. There is an almost infinite variety of these instruments, though they are all constructed upon one or two general plans; in the one the instrument is made to rest upon the vagina and the floor of the pelvis, and upon these supports the uterus is raised and sustained. In the other kind the instrument which sustains the womb is itself supported not by the vagina but by a strap attached to a belt around the waist. The materials employed for the construction of these instruments is usually hard rubber, the object being to employ some material which will not be corroded and become unclean through the action of the vaginal secretions. It is utterly impossible to attempt to describe rules for the application of these instruments, since each must be adapted to the particular wearer with as much care and accuracy as are employed in the fitting of a garment; and this it is hardly necessary to say can be accomplished only by skilled hands. The pessary must, therefore, be selected, adapted and introduced by the physician, who will moreover furnish such instructions as are necessary for the comfort and profit of the patient. Certain rules must be observed in the wearing of pessaries of any sort. Details as to their introduction and withdrawal vary with the different kinds. Most varieties should be removed every day ; many are to be worn only during the day; and there are but few which can be worn with profit and without discomfort during the menstrual period. In every case extreme care as to cleanliness must be observed. Warm vaginal douches should be employed morning and night, and the pessary carefully washed in lukewarm water after every removal. The neglect of these precautions will be followed not only by annoying sensations, but even by serious ulceration of the womb or vagina, or both. In many cases the first attempt at fitting the pessary may be unsuccessful. The instrument may give considerable pain and discomfort. In such cases the patient should at once report the fact to the physician, who will insert an instrument of somewhat different pattern or size or shape. In the worst cases these measures will hardly suffice ; for in some instances the displacement is so great that the womb escapes from the body and appears external to the vaginal orifice. In these cases an operation is usually the only resort which affords any hope of success. In the majority of instances this extreme displacement is a gradual process, accomplished during months or years ; yet in some cases the same amount of displacement - even external to the body-may occur suddenly, as the result of excessive effort in lifting a heavy weight for instance. These cases have been known to occur even in unmarried women. When the womb is thus exposed to unnatural violence, as must, of course, happen in this exposed position, it usually becomes the seat of ulceration and inflammation. One of the first requisites for the treatment of this condition consists, after replacing the organ into the vagina, in absolute rest upon the back in bed. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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