Clinical lectures on stricture of the urethra and other disorders of the urinary organs (1878) (14595038740)

Identifier: clinicallectures00harr (find matches)

Title: Clinical lectures on stricture of the urethra and other disorders of the urinary organs

Year: 1878 (1870s)

Authors: Harrison, Reginald, 1837-1908

Subjects: Urologic Diseases Urethral Stricture Urethra Urinary organs

Publisher: London : J. & A. Churchill Liverpool : Adam Holden

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

Fig. 14.—Staff introduced. turned downwards, the whole length of the stricture is carefullyand deliberately divided on its under surface, and the passageis thus cleared. The director is still held in the same position,and the straight probe-pointed bistoury is run along the groove,to insure complete division of all bands or other obstructions.These being thoroughly cleared, the old difficulty of directingthe point of a catheter through the divided stricture and onwardsinto the bladder is to be overcome. To effect this the point ofthe probe-gorget is introduced into the groove in the director, SEVENTH LECTURE. 77 and, guided by it, is passed onwards into the bladder, dilatingthe divided stricture, and forming a metallic floor, along whichthe point of the catheter cannot fail to pass securely into thebladder. The entry of the gorget into the latter viscus issignalised by an immediate gush of urine along it.

Text Appearing After Image:

Pig. 15. The short catheter is now passed from the meatus downinto the wound ; is made to pass once or twice through thedivided urethra, where it can be seen in the wound, to rendercertain the fact that no obstructing bands have been left un-divided ; and is then, guided by the probe-dilator, passed easilyand certainly along the posterior part of the urethra into thebladder thus (Fig. 15). 78 SEVENTH LECTURE. The gorget is now withdrawn; the catheter fastened in theurethra, and allowed to remain for three or four days; theelastic tube conveying the urine away to a vessel under or bythe side of the bed. After three or four days, the catheter is removed, and isthen passed daily, or every second or third day, according tocircumstances, until the wound in the perinseum is healed; and,after the parts have become consolidated, it requires, of course,to be passed still from time to time to prevent recontraction.* Before concluding these observations, let me say afew words in reference to the

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1878

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