Selected monographs.

Date:: 1888

Credit: Selected monographs. Source: Wellcome Collection.

289/440 (page 271)

$proved that the common retroflexions of the uterus produce hydronephrosis by kinking (Knickung) and downward drag- ging of the ureters. A rarer cause of hydronephrosis in connection with the female generative organs is mentioned by Stadtfeldt (gg), viz. the compression of the ureter by parametric cicatrices. I find a similar observation in Sandifort (loo). Significant cases in point have been quite recently communicated by Frdnkel andilfaass (loi) and by Schottelius (102). The latter found in a woman forty-three years of age the pelvis of the left kidney dilated into a sac holding six litres of fluid, the ureter somewhat dilated and tortuous, but admitting the passage of a probe as far as the bladder. The hydronephro- sis was due to a displacement of the uterus, and fixation of the left ureter by dense connective tissue, the result of former parametritis, to the cervix, above the opening of the ureter into the bladder, ♦ Parametritis may therefore produce obstruction of the- ureter in two ways, either through direct compression of the corresponding ureter by the deposit, or by contraction of the cicatricial tissue drawing the uterus to its own side and thus dragging on the opposite ureter and occluding its calibre. A hseraatometra may also produce hydronephrosis by com- pression of the ureter in the same way as a parametritis, as Tiingel (103) has shown. One of the most important causes of hydronephrosis how- ever, though hitherto little regarded, is descent of the female generative organs first indicated by Virchoiu (104). It seems all the more necessary to consider this cause in the present place, inasmuch as we have already recognised descent of the female generative organs as a cause of moveable kidney itself; so that the relations of descent of the female genera- tive organs to moveable kidney are twofold, contributing as it does directly through traction on the one hand, and indi- rectly through the production of hydronephrosis on the other hand, to the mobility of the kidney. We owe the first observation in which descent of the themselves how far they consider that retroflexion of the utenis has been convincingly proved to he a canse of hydronephrosis. Descent of the- utenas, with or witliout retroflexion, is another matter —Tk\nslatoe.]$

Selected monographs.

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