These redundant vaginal structures usually disappear and contraction takes place after the operation of perineorrhaphy. In some cases, however, when the vagina is very much larger and more relaxed than normal, it is advisable to remove some of the excess of tissue by a plastic operation on the anterior wall similar to that described for the relief of cystocele.
CHAPTER VIII.
THE POSITION OF THE UTERUS AND THE MECHANISM OF ITS SUPPORT.
The uterus normally lies with its anterior surface in contact with the posterior aspect of the bladder, no intestines intervening. The absolute and relative positions of the uterus depend upon the degree of distention of the bladder and the position of the woman. The uterus is pushed backward and the fundus is turned upward by distention of the bladder. When the woman is erect the uterus lies at a slightly lower level than when the woman is on her back, and the intra-abdominal pressure acting upon the posterior surface of the fundus turns the uterus more forward, so that the fundus lies nearer the symphysis pubis. [Fig. 61] shows about the normal range of position.
Fig. 61.—Normal range of position of the uterus, depending upon the distention of the bladder.
It may be said that in the normal woman the long axis of the uterus is approximately perpendicular to the long axis of the vagina ([Fig. 62]).
Fig. 62.—Median sagittal section of the normal female pelvis.