THE REPRODUCTIVE ORGANS OF THE FEMALE. 



Accumulation of menstrual blood in the cavity of the uterus hceinatometra is 

 usually due to congenital stenosis of the cervix or vagina, and may be very great. If 

 the fluid is not evacuated by surgical interference there may be either rupture or ulcer- 

 ative perforation of the uterus. The blood may escape into the abdominal cavity, or 

 be shut in by adhesions, or perforate into the bladder or intestines. Sometimes the 

 blood passes into the Fallopian 

 tubes, dilates them, and escapes 

 through their abdominal ends. 



Changes in Position. 



The body of the uterus may 

 become fixed in an abnormal po- 

 sition, while the situation of the 

 cervix is unchanged. 



FLEXION. The body may be 

 bent forward anteflexion; back- 

 ward retroflexion (Fig. 421) ; or 

 sideways lateral flexion. The 

 flexion may be slight, or so 

 great that the neck and body 

 form an acute angle. Ante- 

 flexion is the most common va- 

 riety, and that in which the 

 flexion is greatest. Peritoneal 

 adhesions, flaccidity of the 

 uterine walls, particularly after 

 delivery, atrophy of the walls, 

 ovarian and other tumors, etc., 

 are the usual causes of flexion. 



VERSION of the uterus consists 

 in an abnormal inclination of the 

 long axis of the organ to that of 

 the vagina. The uterus may be 

 inclined backward, forward, or 

 to one side. 



Retrotersion is the most com- 

 mon. The fundus uteri is di- 

 rected backward and downward, 

 the cervix forward and upward. 

 This condition is found in vari- 

 ous degrees; in the highest the 

 fundus lies in Douglas' cul-de-sac with the cervix upward, so that the axis of the 

 uterus is parallel to that of the vagina, but in a direction nearly opposite to the normal. 

 Abnormal looseness of the uterine ligaments, abnormally large capacity of the pelvis, 

 enlargement or tumors of the uterus, and pregnancy during the first four months, are 

 some of the more common conditions under which this lesion occurs. 



Anteversion. Inclination of the fundus forward and downward, and of the cervix 

 backward and upward, is not common and seldom reaches a high degree. It occurs 

 under the same general external conditions as anteflexion. 



Laterorersion is not very common as a simple lesion, but is not infrequently com- 

 bined with other displacements. It may be produced by congenital shortening of one 

 of the broad ligaments, by adhesions, or by the pressure of tumors. 



The greater degrees of version may produce very grave lesions. The urethra and 

 rectum may be compressed. Cystitis, perforation of the bladder, dilatation of the 

 ureters and hydronephrosis, and fatal obstruction of the bowels may follow. If preg- 

 nancy exist abortion may take place, or the inverted uterus may be forced through the 

 peritoneum and posterior wall of the vagina and project through the vulva. In the 



FIG. 421. RETROFLEXION OF THE UTERUS. 



Small cysts may be seen in the mucous membrane of the 



body. 



