File:A Complete practical work on the nature and treatment of venereal diseases, and other affections of the genito-urinary organs of the male and female (1848) (14763917961).jpg

Identifier: completepractica00bost (find matches)
Title: A Complete practical work on the nature and treatment of venereal diseases, and other affections of the genito-urinary organs of the male and female ..
Year: 1848 (1840s)
Authors: Bostwick, Homer
Subjects: Sexually transmitted diseases
Publisher: New York, Burgess, Stringer & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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al operation. Modern authors have recommendedfive different kinds : First, to puncture the bladder above the pubis, which is themost objectionable: Second, to puncture it through the rectum, which may be donewithout much difficulty, but it is merely temporary, and does not remove the stric-ture : Third, to open the urethra from without, and continue the operation by cut-ting through the strictured part: Fourth, to divide the stricture and re-open thepassage by an instrument passed through the urethra : Fifth, by a combination ofthese two last modes. The surgeon has now to decide which of these various plans he will select. Thelatest and best authorities condemn the operation above the pubis, as being fraught TRE \tmi:\ i OF 8TRICT1 RE 281 with consecutive dangers, from which the other methods are more exempt, li* the bladder have risen high into the abdomen, together with its peritoneal covering, thepuncture is effected in this situation by a simple division of the skin and separation
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MODE OF PUNCTURING THE BLADDEIi. Surgical anatomy of the Bladder.—The walls of the abdomen and pelvis have been removcijon the left side, a portion of the bladder excised, and the penis and prostate cut through on the middle , 282 TREATMENT OF STRICTURE. of the recti and pyramidalis, and the bladder is perforated by a straight long trocarand canula. It is highly important to retain the canula, and every method must beadopted to insure the patient against the danger of infiltration. I should say thatthis operation ought never to be resorted to in retention of urine from stricture ; incases of retention from enlarged prostate gland, it may be preferable, sometimes, toany of the other methods of opening the bladder. The operation through the rectum, when there is no considerable enlargement ofthe prostate gland to interfere, may be performed very easily, and Sir BenjaminBrodie, in his excellent work, seems inclined to give it the preference. The sim-plicity and safety of puncturing thr

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