File:Minor surgery and bandaging, including the treatment of fractures and dislocations (1891) (14761820384).jpg

Identifier: minorsurger00whar (find matches)
Title: Minor surgery and bandaging, including the treatment of fractures and dislocations ..
Year: 1891 (1890s)
Authors: Wharton, Henry R. (Henry Redwood), 1853-1925
Subjects: Surgical Procedures, Minor Bandages and bandaging Bandages
Publisher: Philadelphia, Lea brothers & co.
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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is at times called upon to employ,and its passage through a healthy urethra is a matter oflittle difficulty. For the introduction of a catheter thepatient may be in the standing, sitting, or recumbent pos- 210 MINOR SURGERY, ture, and the latter is the best in most cases; he should restsquarely on his back and have the thighs a little flexed andseparated. Fig. 138. Fig. 139. Fig 140. (/ 10-14 Filiform bougies. Steel sound. Sound for dilating meatus. Before passing a metallic catheter the surgeon should seethat it is perfectly clean, and after warming and oiling ithe stands upon the left side of the patient and grasps thepenis with the left hand, and turns it over the pubis andintroduces the beak of the catheter into the meatus, and INTRODUCTION OF A CATHETER. 211 gently passes it along the urethra until its point passesbeneath the symphysis pubis ; at this point the handle iselevated and gently depressed between the thighs, and thebeak will pass into the bladder. (Fig. 141.) Fig. 141.
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Introduction of catheter. (Voillemier. When the prostatic region is reached difficulty is some-times experienced in passing the catheter; this may beovercome by introducing the finger into the rectum andguiding the catheter through this, or if the prostate is foundmuch enlarged the catheter should be withdrawn, and aprostatic catheter (Fig. 133) should be substituted for it. The same manipulation is made use of in passing metallicsounds. 212 MINOR SURGERY. Flexible catheters and bougies are passed by graspingthe penis and holding it in such a position that it is at aright angle to the axis of the body, and the catheter orbougie is passed into the meatus and carried through theurethra into the bladder by gently pushing the instrumentdownward. In this variety of catheter, which has no curve, the surgeonhas no means of .guiding the point of the instrument, andif an obstruction is met he should withdraw the instrumentslightly and make another attempt; all manipulations shouldbe extremely

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