After the instrument is withdrawn the cervical canal and the vagina should be washed out with a 1:2000 solution of bichloride of mercury, and a light gauze pack should be introduced into the vagina. The pack should be removed at the end of forty-eight hours, and a daily douche of 1:4000 bichloride solution should be administered for the following week. The patient should remain in bed for two weeks, or longer if there is any pelvic pain. Pain, however, does not follow this operation if we avoid operating upon those cases in which there is inflammatory disease of the tubes and ovaries. The too early resumption of the erect position may cause the failure of the operation. The abdominal pressure exerted upon the fundus uteri, before the organ has become fixed in its altered shape, may bring about a recurrence of the anteflexion. In case the external os be very small--too small to admit the dilators--it may be incised by small crucial incisions or reamed out with the closed blades of the scissors. Dilatation of this kind usually produces a permanent broadening and shortening of the cervix. The cervical canal is rendered straighter and larger. The good effects of the operation are not always apparent at the menstrual period immediately following the operation, because the results of the traumatism to the mucous membrane and the structures of the cervix are still present. At the periods after this, however, the dysmenorrhea is absent or is very much relieved. The benefit usually derived from this operation is a strong proof of the truth of the obstructive theory of the dysmenorrhea. If, after dilatation, conception takes place, the woman may look forward to perfect cure. In some cases the dilatation does not seem to be sufficient to produce a permanent open condition of the cervical canal, and the signs of obstruction (dysmenorrhea) return. In such a case the dilatation should be repeated. The more thoroughly the dilatation is performed the first time the less often will the second operation be necessary. CHAPTER XI. RETROFLEXION AND RETROVERSION OF THE UTERUS. =Retroversion= of the uterus means a turning back or a backward rotation of that organ. The shape of the uterus may not be altered. The fundus, instead of lying forward upon the bladder, is directed backward, and sometimes lies in the hollow of the sacrum (Fig. 86). [Illustration: FIG. 86.--Retroversion of the uterus.] =Retroflexion= means a bending backward of the uterine axis. The axis of the body of the uterus is normally inclined forward at an obtuse angle with the axis of the cervix. When the axis of the body of the uterus is inclined backward at an angle with the axis of the cervix, retroflexion exists. Retroflexion may vary in extent from an angle very little less than 180 degrees to an angle considerably less than 90 degrees (Fig. 87). [Illustration: FIG. 87.--Retroflexion of the uterus.]