Identifier: systemri01hirs (find matches)
Title: A system of obstetrics
Year: 1888 (1880s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia, Lea brothers & co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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and ANOMALIES OF THE SOFT PARTS. 713 labor: by cystocolpocele is meant prolapse of the bladder into thevaginal passage; and if the sac occupies the cavity of the pelvis, fillingthe hollow of the sacrum, pushing the os uteri beyond reach andoccluding the vaginal passage, it is complete. One of the most markedresults of this displacement of the bladder is lingering labor. Thediagnosis is made by introducing the catheter into the bladder andevacuating it. This displacement of the bladder in relation to preg-nancy and labor was very fully considered by Broad bent in 1863 in apaper read before the London Obstetrical Society. In referring to thediagnosis he states : The prolapsed condition of the bladder is readilyrecognized on examination, especially when it contains urine in any Fig. 274.
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Cystocele complicating Pregnancy. considerable quantity. The cavity of the pelvis is found to be occu-pied by a bag of fluid easily distinguished from the foetal membranesby the fact that it springs from the pubis, and does not permit the fin-gerto pass between it and the symphysis. As this sac, the bladder,fills up the hollow of the sacrum, the os uteri cannot be reached tillthe urine is evacuated ; and if this is done by the catheter, the instru-ment can be felt from the vagina and followed to every part of the 714 ANOMALIES OF THE FORCES IN LABOR. bladder. When the bladder is perfectly empty the displacement may-be overlooked, bat the finger, instead of circumscribing the lower seg-ment of the uterus readily, meets anteriorly with the bladder, passingfrom the symphysis pubis to the uterus, and usually disposed in rugae;the introduction of the catheter at once makes the case clear. Whether known as cystocele, prolapse of the bladder, or cystocolpo-cele, the obvious indication is to

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