File:Gonorrhea in the male - a practical guide to its treatment (1911) (14593351328).jpg

Identifier: gonorrheainmalep00wolb (find matches)
Title: Gonorrhea in the male : a practical guide to its treatment
Year: 1911 (1910s)
Authors: Wolbarst, A. L. (Abraham Leo), 1872-
Subjects: Gonorrhea Gonorrhea
Publisher: New York : International Journal of Surgery
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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FlG. 27. Otis Urethrometer. serted into the urethra the latter should be testedby quickly expanding the extremity to its maximumextent (45 French). This insures the trustworthi-ness of the rubber cover. The instrument is steril-ized, cover and all, and introduced gently down tothe deep urethra, the bulb being at its minimum(15 French). This dilatable bulb is now expandedby turning the revolving cap up to 30 French, asper index, and the instrument gently drawn forwardtoward the meatus (Fig. 28). Any infringementon the urethral caliber is made evident by an in-terference, greater or less, with the passage of theinstrument. If the instrument, keyed up to 30 118 Gonorrhea in the Male. French, passes from the urethral bulb to the meatuswithout interference, we can safely eliminate thepresence or even the possibility of a stricture in theanterior portion of the urethra. For the examina-tion of the deeper parts, a blunt sound, 28 Frenchcaliber, should be passed down into the bladder. It
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Fig. 28. The Otis Urethrometer in position. the meatus is too small to admit so large a sound,ii should be enlarged. There is no good substitutefor this procedure. If the sound passes into thebladder without difficulty, the possibility of a deep-seated stricture may be eliminated. The examina-tion should be followed by an intra-vesical irriga-tion. Of course, it goes without saying that bothof these procedures require the utmost gentleness Urethral Examination. 119 and refinement of technic; otherwise their useful-ness as diagnostic aids is not alone destroyed, butthey accomplish positive damage. This is true of allurethral instrumentation. The final step in the diagnosis of chronic ure-thritis brings into use the urethroscope. Thisgives us the last word on the subject, at least asfar as the anterior urethra is concerned. Thetechnic is extremely simple. Eeading and inter-preting the findings are not so easy, however. Forgeneral use I prefer the Chetwood instrument.The tube and its obt

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