644 Diseases of the Genital Organs 



The prognosis of cervical prolapse is generally unfavor- 

 able, because the underlying causes are not often easy to 

 remove. In the pregnant animal the prolapse, with the as- 

 sociated cervicitis, not infrequently renders parturition, 

 abortion or extraction of the fetus difficult and imperils the 

 life of the patient through sepsis or pyemia. The cervical 

 prolapse in nymphomania indicates a serious type of ovarian 

 disease, which is aggravated by the prolapse. 



The handling varies according to the state of the patient 

 and the underlying cause. In the pregnant animal it should 

 be determined first whether the fetus is alive. This is best 

 accomplished by rectal palpation. The fetus is usually pal- 

 pable and some part of it can be grasped. When pressure or 

 traction is exerted upon a fetal part, if alive, the fetus al- 

 most invariably attempts to pull the extremity away. If 

 the fetus is alive, the handling should be purely palliative 

 and an earnest effort made to get the diseased parts in the 

 best possible condition for the eventual expulsion or ex- 

 traction of the fetus. For this purpose the vulvar sutures 

 described under Vaginal Hernia in Chapter V, and illus- 

 trated in Fig. 60, can be made to serve the highly useful 

 purpose of retaining the cervix within the vagina and pro- 

 tecting it against the irritating effects of desiccation when 

 exposed to the air, and from becoming contaminated through 

 contact with bedding and filth. It is best to use heavy silver 

 wire and secure the apposition of the vulvar lips by merely 

 hooking the free ends of one side over the wire of the other. 

 Then, if parturition begins in the absence of the attendant, 

 the force unbends the hook and releases the suture. At the 

 same time any existing inflammation may be ameliorated by 

 douching the vagina, and that portion of the cervix project- 

 ing into it, with warm 0.25 per cent. Lugol's solution or 

 saturated boric acid solution, or by applying to the parts an 

 ointment of bismuth subnitrate, iodoform and petrolatum. 

 While dressing the parts the sutures should be released in 

 order that the fluids may be freely expelled. 



When time for parturition arrives, it' the cervix is too dis- 

 eased to permit efficient bloodless dilation, the constricted 



