A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
_Fibroid Tumors of the Vagina._--Fibroid tumors sometimes occur in the
vagina. They are usually found in the upper part of the anterior wall.
They are sometimes adherent to the urethra. They are usually of small
size, but may attain a diameter of six inches. The treatment of such
tumors is removal.
Cancer and sarcoma may attack the vagina, though these diseases as
primary conditions are very rare. When possible, complete removal
should be done.
=Atresia of the Vagina.=--Severe puerperal infection or mechanical
injury, followed by extensive destruction of the tissues of the vagina,
may result in a cicatricial narrowing or complete closure or atresia of
the vaginal canal.
The _symptoms_ of this condition are due to retention of the uterine
discharges. There is no discharge of menstrual blood from the vagina.
Attacks of pain occur periodically at the menstrual periods. A cystic
tumor, which may be felt by rectal examination, is present. The tumor
consists of the distended portion of the vaginal canal (hematocolpos),
and sometimes of the distended cervical canal and body of the uterus.
The contents of the hematocolpos are usually sterile, although they may
become purulent (pyocolpos).
The _diagnosis_ is readily made by vaginal and rectal examination.
_Treatment_ consists in incision and excision of the vaginal septum
and the suture of the vaginal mucous membrane above to that below
the obstruction. In very severe cases it is difficult to maintain
the patulous condition of the vaginal canal on account of subsequent
cicatricial contraction. In such cases the repeated passage of vaginal
bougies or the transplantation of mucous membrane has been resorted to.
=Vaginismus.=--The term “vaginismus” has been applied to a condition
characterized by a spasmodic contraction of the muscles which close the
vaginal orifice. The muscular spasm occurs reflexly when penetration
of the vagina is attempted, as at coitus or a digital examination. The
condition is due to dread of pain, and is usually the result of some
painful local lesion, such as a urethral caruncle, fissures or sores
of the vulva or anus, etc.; or it may be due to some painful condition
of the tubes and ovaries. Similar contraction is observed in the
sphincters of the anus when there is present a painful anal lesion.
Vaginismus has been said to occur in neurotic and hysteric women in
whom there was no discoverable local lesion.
_Treatment_ consists in the removal of any local cause of pain or
irritation.
If the reflex spasm of the muscles persists when coitus is attempted,
notwithstanding the removal or the absence of any discoverable local
cause, operative measures have been advised.
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