File:Clinical lectures on stricture of the urethra and other disorders of the urinary organs (1878) (14801612473).jpg

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

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ibbed forceps, and held apart. The staff is then to be gentlywithdrawn until the button-point appears in the wound. It isthen to be turned round, so that the groove may look to thepubes, and the button may be hooked into the upper angle ofthe opened urethra, which is then held stretched open at threepoints thus (Fig. 14), and the operator looks into it immediatelyin front of the stricture. Whilst thus held open, the probe-pointed director is inserted into the urethra ; and the operator,if he cannot see the opening of the stricture, which is oftenpossible, generally succeeds in very quickly finding it, and 76 SEVENTH LECTURE. passes the point onwards througit the stricture towards thebladder. The stricture is sometimes hidden amongst a crop ofgranulations or warty growths, in the midst of which the probe-point easily finds the true passage. This director having beenpassed on into the bladder (its entrance into which is clearlydemonstrated by the freedom of its movements), its groove is
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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.

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