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ondary to that of Buying Yasmin Online the male perineum, emphasizing only the important structural diiJerences. Probably this custom originated at a time when gynecology was little studied and operations were relatively much more frequently performed on the male per- ineum than on the Yasmin Generic Brand female. The pelvis floor is made up of skin, superficial and deep fasciae, and muscles The muscles are eight in number — two ischiocavernosi, two bulbocavernosi, two transverse perineal, the levator ani and the sphincter ani. These muscles blend with each other and form a complete muscular diaphragm, which fills the bony outlet of the pelvis. These muscles are still further strengthened bv lav- nber 6, 1920.] CUMMINGS: INJURIES TO PELVIC FLOOR 719 €rs of strong pelvic fascia which bind them together and increase their power. The muscular elements which enter into the construction of the floor are its chief source of strength, and the levator ani is the most important of all muscles, as the support which is afiforded to the pelvic viscera depends entirely upon Ocella Generic For Yasmin its integrity. Zarah Generic For Yasmin If we compare the perineal region of a woman who has not borne children wnth that of one who has, a difference is Yasmin Generic Name at once noticed. A diflference exists €ven though there has been no visible tear in the sec- ond woman or only a tear which has been treated by the usual primary operation. If the nullipara is young and a virgin it will be seen that the anus is well Yasmin 28 Generic forward and that the perineal body is short in its Buy Generic Yasmin ventrodorsal diameter. In a woman who has given birth to a child the anus Generic Form Of Yasmin is always displaced Buy Yasmin Uk dorsally. If the perineal body is superficially intact the ventro- dor.sal diameter will be greatly lengthened; if torn, the perineal body will be shortened, the mucous membrane everted, and the vulva will gape. If torn and repaired primarily, the perineal body will be lengthened ventrodorsally and, therefore, shortened vertically. The dorsal displacement of the anus is a Buy Yasmin Online Uk constant deformity. There are three types of in- jury of the pelvic floor : superficial median tears, median tears involving the sphincter ani, and lateral tears involving the Yasmin Generic Price vaginal sulci. SUPERFICIAL MEDIAN Yasmin 3 Mg TEARS A superficial median tear extends in the median line from the fourchette either backward toward the anus or upward into the vagina or both. It splits the tissues between the posterior border of Generic Version Of Yasmin the vul- vovaginal orifice and Yasmin Ed Tablets the anus, and occasionally ex- tends internally an inch or more Generic Brand For Yasmin up the posterior wall of the vagina. These tears are of no practical im- portance as the integrity of the levator ani muscle is not damaged nor destroyed. Occasionally, how- ever, the cicatrix which is formed may become irri- table and cause local tenderness and reflex disturb- ances. M EDI AX TEARS Median tears involving the sphincter ani extend backward in the median line from the fourchette through the sphincter ani muscle, and in some cases may continue up the rectovaginal septum for a dis- tance of an inch or more. Sometimes all the fibres of the sphincter are not completely divided and the appearance of the tear may be deceptive. These tears permanently destroy the function of the sphincter nniscle. The levator ani muscle is not torn and consequently the supporting power of the pelvic floor remains unimpaired. LATERAL TEARS Lateral tears involving the vaginal sulci extend from the fourchette up into one or both of the va- ginal sulci and are usually accompanied by a super- ficial median tear toward the anus. This laceration is, as a rule, bilateral, though in rare cases the in- jury may occur on only one side of the vagina. In this type of laceration the function of the levator ani muscle is destroyed and the pelvic organs, as well as the Yasmin 21 Tablets terminal ends of the urethra, vagina and rectum, are no longer supported or maintained by the pelvic floor. As a rule involution of the uterus and vagina is arrested and in time the uterine ligaments as well as the pelvic connective tissue become elongated and stretched, resulting in prolapse of all the pelvic organs. The treatment of lacerated perineum and of in- juries Generic Yasmin Zarah Generic Brand Of Yasmin to the pelvic floor is exclusively surgical. Generic Name For Yasmin Un-

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