Fibromyoma in Cul-de-sac of Douglas

1902 American Journal of the Medical Sciences  
from a careful analysis of the record of Schanta'a clinic finds that a little over 14 per cent of the cases of cancer of the uterus were oper¬ able. Of these, 8.8 per cent, succumbed to the operation. The writer con¬ cludes that less than 4 percent, of all patients with uterine cancer are really cured by radical operation. Dysmenorrhea.-MrnGE (Ccnlralblalt fur Gynakologic, No. 50, 1901) distinguishes two forms of dysmenorrhea, the so-called idiopathic, which is independent of pelvic disease,
more » ... pelvic disease, and the " secondary" which is due to disease of the genital tract The writer believes that painful menstruation, from whatever cause, is referable to the tendency to uterine contraction which is present at the time of the monthly period. These are due not only to the premenstrual swelling of the endometrium described by Fritsch, but also to the mere presence of blood within the uterine cavity, which acts as a foreign body. These contractions in healthy women are insensible. In hysterical or neurasthenic subjocts, on the contrary, the uterus, though entirely normal, is hypenesthetic and dysmenorrhcea results. Mechanical obstruction to the escape of -blood, added to this hyperesthesia, increases this pain. In dis¬ eased conditions of the pelvic organs the dysmenorrhcea is more pronounced, especially if the two former factors are also present. Hence the deduc¬ tion: Normal menstruation, as well as dysmenorrhcea, is accompanied by pains simulating labor-pains, although the latter may be entirely of nervous origin. It follows that local treatment alone is not sufficient to insure permanent relief, but the general nervous condition of each patient must be carefully considered. The writer rejects the theory of a reflex nasal origin of dysmenorrhoea. Though he has seen some brilliant results from cocainization of the nasal mucous membrane, he is inclined to regard this as principally an application of the method of suggestion. Fibromyoma in Cul-de-sac of Douglas.-Rosexsteix (Cenlralblail fur Ggndkologic, No. 50, 1901) reports a case of tumor in Douglas' pouch, which was diagnosed as an ovarian cyst with twisted pedicle. On opening the abdomen a fibromyoma was found behind the uterus with a pedicle, which was attached to the right side of the cul-de-sac. There were numer¬ ous intestinal adhesions. The writer inferred that the growth developed
doi:10.1097/00000441-190204000-00025 fatcat:dzfoaae55fhnvnsqxbprtqbdqq