File:A manual of operative surgery (1910) (14783307533).jpg

Identifier: manualofoperativ0001trev (find matches)
Title: A manual of operative surgery
Year: 1910 (1910s)
Authors: Treves, Frederick, Sir, 1853-1923 Hutchinson, Jonathan, 1859-1933
Subjects: Surgical Procedures, Operative Surgery
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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hrough the urethra, and this should be favoured by * Mr. Lynn Thomas has invented a kind of metal spoon, one end of which isintroduced into the rectum and made to elevate the prostate by depression of theother end, or handle, of the instrument between the patients thighs. We do notsee any advantage to be gained from this metal elevator, as the fingers are sensitiveand therefore better adapted for the purpose. t The use of the apparatus described and figured on page 581 will helpmaterially in keeping the patient dry and clean. It is, however, somewhat irksometo wear. chap, xxiv) SUPRAPUBIC PROSTATECTOMY 661 keeping the patient in the sitting posture and getting him outof bed as soon as possible. After prostatectomy a pouch is left of varying dimensionswhich is not lined with normal mucous membrane, and whichhas slowly to contract. Phosphatic deposit readily occurs inthis pouch, and hence care should be taken to keep the urineslightly acid. Now and then a calculus forms during convales-
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ce?. FIG. l8l.—THE BLADDER, OPENED FROM THE FRONT, FROM A CASE OF SUPRAPUBICPROSTATECTOMY. THE PATIENT DIED A FEW DAYS AFTER OPERATION. P.S., Large space or cavity left by removal of the prostate ; C.L., Thin capsule of tissue, chieflyglandular; P.u., Part of prostatic urethra left; v.m. , Verumontanum ; c., Contractedupper part of bladder ; v.w., Muscular vesical wall. cence, in that case lithotrity may become necessary. Anothertroublesome complication is obstruction of the vesical orificeby a valvular flap of mucous membrane. Finally there is nodoubt that contraction may lead to a true stricture, and atpresent it is impossible to say how often this occurs. (A.Edmunds, Practitioner, January, 1908.) 662 ABDOMINAL OPERATIONS (part ii If the entire obstruction has been removed, the bladderwill regain control in from a month to six weeks after the opera-tion. The condition of vesical atony which was supposedto be present in many cases of prostatic enlargement appears tohave no real exi

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