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
The pressure of the displaced fundus upon the rectum may also give
trouble. Women in this condition often complain of a feeling of
obstruction in the rectum. Pressure upon the hemorrhoidal veins results
in hemorrhoids.
There usually accompanies retroversions of the uterus a backward and
downward displacement of the ovaries--in other words, a prolapse of the
ovaries.
The =symptoms= of retrodisplacement are numerous, and may be referred
directly to the altered position of the uterus and the accompanying
conditions. There are backache situated in the upper part of the
sacrum, and headache situated on the top of the head or in the occiput.
These may be considered the two constant symptoms. There is a feeling
of weight and dragging in the pelvis, extending down the thighs.
Physical weakness, or inability to walk or stand for more than a short
time, is often very marked, and seems to be out of all proportion to
the lesion of the uterus. The manner in which such weakness of the
legs is produced is not very evident. That it is caused directly by
the displacement of the uterus, however, is proved by the fact that it
disappears as soon as the uterus is restored to its normal position.
The accompanying prolapse of the ovaries produces symptoms referable to
these organs, the chief symptom being pain in each ovarian region.
The irritability of the bladder has already been spoken of. Menorrhagia
and leucorrhea may be present as a result of the congestion and the
chronic inflammation of the endometrium. Menstruation is usually
painful. At the menstrual period the backache, headache, ovarian pain,
and vesical disturbance are increased. Dysmenorrhea due to obstruction
is unusual in cases of retroflexion. Retroflexion usually occurs in
parous women, in whom the cervical canal is large, and the flexion
therefore does not cause sufficient obstruction to impede the escape
of menstrual blood. All the symptoms arising from retroversion of the
uterus are ameliorated by the recumbent posture.
The =diagnosis= of retroversion and retroflexion of the uterus is
very easily made by bimanual examination. The abdominal hand fails to
find the fundus in the normal position. The vaginal finger feels the
cervix uteri directed not backward toward the coccyx, but forward in
the direction of the vaginal axis or toward the symphysis pubis. The
posterior wall of the cervix and the body of the uterus may be plainly
felt inclined backward. In case of retroflexion the angle of flexion
may be felt by the vaginal finger.
The accompanying prolapse of the ovaries is usually very easily
demonstrated by vaginal touch.
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