604 PLAIN FACTS FOR OLD AND YOUNG 



In a case recently under the care of the author, the 

 amount of prolapsus was so great that the urethra was 

 doubled upon itself, so that the bladder could not be 

 evacuated without pressing backward on the prolapsed 

 portion with the hand. In consequence of the reten- 

 tion of urine, the bladder being seldom emptied, disease 

 of the bladder is likely to be set up, with its many 

 attendant inconveniences and often great suffering. 



The most common cause of this condition is pro- 

 lapsus of the womb. It is frequently met with in its 

 worst form in elderly women who also suffer with 

 rectocele. In several cases which have come under the 

 care of the author, the patients have been quite ad- 

 vanced in life, several years past the menopause, and 

 the difficulty has been due to a tear in the perineum, 

 followed by great relaxation of the vaginal walls. By 

 means of a proper surgical operation, the difficulty is 

 wholly curable; but little can be done for its relief by 

 home treatment, aside from the employment of hot 

 vaginal douches and solutions of tannin and other 

 astringents, which, of course, afford only temporary 

 relief. 



Treatment.— The remarks made respecting the treat- 

 ment of rectocele are equally applicable to this condi- 

 tion. A surgical operation is sometimes required, al- 

 though, as a rule, surgical measures are of very little 

 value unless accompanied or succeeded by measures cal- 

 culated to strengthen the abdominal walls and support 

 the abdominal organs. The abdominal supporter is of 

 great value in these cases, as a palliative until the 

 abdominal walls have acquired sufficient strength to 

 support the tension of the abdomen. In cases in which 

 women have borne many children, the muscular struc- 

 tures of the abdominal walls are so greatly weakened 



