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INTERPOSITION OF THE UTERUS (Latin the inter-prefix between + positio installation, landing) — the gynecologic operation eliminating a prolapse of the uterus by its room between a bladder and a vagina. The first message about And. in m it was made in 1901 S. A. Alexandrov. Similar operations were offered by F. Schauta, E. Vertgeym and Watkins (Th. J. Watkins). And. m make in those cases of a prolapse of the uterus when other methods of operational treatment are inapplicable.

the Diagrammatic representation of position of a uterus and bladder after operation of interposition: 1 — a bladder; 2 — a uterus; 3 — a front wall of a vagina; the front wall of a uterus is fixed by seams to a front wall of a vagina.

Indications and Contraindications

Indications: an incomplete frank prolapse with considerable omission of a back wall of a bladder (tsistotsela) at elderly women. Contraindications: childbearing age of the patient, full prolapse of the uterus, patol, changes of a neck of uterus (erosion, leukoplakia, etc.), malignant tumors of generative organs.

And. m carry out vulval access under anesthetic, less often under local anesthesia. After an otseparovyvaniye of an oval rag of a front wall of a vagina (see. Colporrhaphy ) otslaivat a bladder from a neck of uterus to a vesicouterine fold of a peritoneum, to-ruyu then open. In the formed opening remove the body of the womb rejected kpered, and separate catgut seams hem a peritoneum to a back surface of a uterus at the level of an isthmus of a uterus; the uterus with appendages refuses located vnebryushinno. Then on a vaginovesical partition put a purse-string stitch, and fix a front wall of a uterus to a front wall of a vagina. As a result of it the bladder is located on a back surface of the uterus (fig.) creating for it a support. Operation is finished with the back plastics recovering an integrity of muscles of a pelvic bottom (see. Colpoperineoplasty ).

Bibliography: Persianinov L. S. Operational gynecology, M., 1976, bibliogr.; T e L inde R. W. a. M a t-t i n g 1 at R. F. Operative gynecology, Philadelphia — Toronto, 1970.

A. P. Kiryushchenkov.