File:Clinical lectures on the surgical diseases of the urinary organs (1908) (14780804485).jpg

Identifier: clinicallectures1908frey (find matches)
Title: Clinical lectures on the surgical diseases of the urinary organs
Year: 1908 (1900s)
Authors: Freyer, P. J. (Peter Johnston), Sir, 1851-1921
Subjects: Genitourinary organs Urogenital System Urogenital System Urethra
Publisher: New York : William Wood & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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cut through on one aspect. Having satisfied ourselves that the stricture has beenthoroughly divided, we introduce a large gum - elasticcatheter, No. 23 or 24 F. (12, 13 E.), draw off the urineand any blood that may have trickled into the bladder, andthen wash out the latter with a saturated solution of boricacid by means of a metal syringe or irrigator. I formerlyused solution of perchloride of mercury (1 in 6,000), butfound that it irritated the bladder, and induced constantdesire to micturate when the patient woke from the anaes-thetic ; whereas our aim should be to have the bladder 4- OPERATIVE TREATMENT OF STRICTURE completely at rest, so that no urine may be passed for several hours after the operation. The gum-elastic catheteris then tied in the bladder, in the manner already Indicated: forty-eight hour.-, and the urine allowed to passin this way. Maissoneuves Method.This (Fig. 19) is Maissoneuves urethrotome, hut I considerTevans modification of it (Fig. 20) the safest and most
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efficient foi dividing th< stricture from before backwards. A filiform flexible bougie, provided with a female screu at • ■ introduced through the stricture into the bladder. TYn thin te 1 g v< d itafl 1 * rew< d on to this. The 1 onducting staf) p 1 on through the itricture, l,,l i,\ the filiform bougie, whi< h curls up in the bladdi 1. Th- 1 onduc tor i h< Id stead) bj an .1 li;tant. The h- athed blade 1- nou in erted in the groove oi th( OPERATIVE TREATMENT OF STRICTURE 43 metal conductor, and pushed along till the sheath isobstructed by the anterior surface of the stricture, when thesharp blade is boldly projected against it by means of thebutton at the end of the handle, cutting partly through themorbid tissue, and then allowed to recoil back into the sheath,which it does by the force of a spring in the handle. Thesheath is again pushed further home and the blade is oncemore projected, and so on till all resistance ceases, thestricture or strictures being cut t

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