Prolapse of the ovaries / by Paul F. Mundé.

  • Paul F. Mundé
Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: Prolapse of the ovaries / by Paul F. Mundé. Source: Wellcome Collection.

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    passed to project into the peritoneal cavity ; 2d, by the ovarian ligament, a strong round cord of 2.5 to 3 cm. in length, which attaches the inner edge of the ovary to the uterus directly below and behind the tubal origin ; the ova¬ rian ligament consists of smooth muscular fibres and peri¬ toneal envelope ; 3d, by the infundibulo-ovarian ligament, a slender band of connective tissue attaching the outer edge of the ovary to the infundibulum tubse, and preventing the separation of these two organs ; this ligament is continued under the name of the infundibulo-pelvic ligament to the posterior part of the iliac fossa, and divides the pelvic peri¬ toneum into two pouches, the shallow utero-vesical or para¬ vesical pouch anteriorly, and the deep Douglas’ pouch pos¬ teriorly. A very slight support may be afforded by the thickening of the upper border of the broad ligament by the Fallopian tube. From these relations, it is apparent that the ovary, at¬ tached as it is to its adnexa by a slender cord and by mova¬ ble folds of peritoneum, is movable to a certain extent under normal conditions. Thus it rises and falls with the fundus uteri during pregnancy and after parturition respectively, and slightly changes its position with the normal physiolog¬ ical deviations of the uterus. So also does it accompany the uterus in its increase from tumors, and it may, under certain conditions of traction by adhesions with intestines or violent vis a tergo, accompany or follow the usual con¬ tents of an inguinal, crural, obturator, or ischiadic hernia. Such extra-pelvic displacements of the ovary are, however, according to Deneux 1 and English,2 chiefly congenital. The projection of the ovary posteriorly, the mobility of the broad ligaments and their inclination downwards and backwards, show the tendency of the ovary to glide into Douglas’ pouch, — a tendency materially increased by the lengthening of the ovarian ligament in consequence of re¬ peated pregnancies and the dragging of the enlarged ova- ries. This explains why, although the ovaries of virgins 1 Sur Phernie de Vovaire, Paris, 1813. 2 Medizinische Jahrbiicher, 1871.
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