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CHAPTER V
HYSTERECTOMY AND MYOMECTOMY
Hysterectomy is the name applied to the surgical operation for the removal of the uterus.
Indications. Hysterectomy is mainly required in the radical treatment of fibroids and malignant disease (carcinoma, sarcoma, and chorion-epithelioma). It is occasionally required for injury, and certain morbid states due to acute and chronic sepsis; and for a condition but little understood, termed generically fibrosis. Hysterectomy is also carried out for such conditions as diffuse adenomyoma of the uterus, hæmato-metra, tuberculous endometritis, and on rare occasions for chronic inversion of the uterus and inveterate dysmenorrhœa.
The presence of fibroids in the uterus is a common cause for which hysterectomy is required, and the history of this operation is full of interest.
The uterus may be removed by two methods. In one, access is obtained to the uterus through an incision in the belly-wall; this is termed abdominal hysterectomy. In the other, the whole uterus is extirpated through the vagina, and on this account it is termed vaginal hysterectomy or colpo-hysterectomy.
The abdominal method of removing the uterus may be performed in two ways:—