File:The Cleveland medical journal (1910) (14586580190).jpg

Identifier: clevelandmedical09clev (find matches)
Title: The Cleveland medical journal
Year: 1910 (1910s)
Authors:
Subjects: Medicine Medicine
Publisher: Cleveland : The Cleveland Medical Journal Company

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s Fig. I 708 The Cleveland Medical Journal employed drainage in 34. I am unable just now to give the exacttime of convalescence in each case but approximately the drain-age cases have required from three to four weeks longer than theimmediate closure cases, and have generally had an annoyingperiod of convalescence with dirty bladders which required irri-gation afterward. The closure cases have averaged from twoto three weeks for convalescence and have generally been upand about in from ten days to two weeks. The bladders wereirrigated through the urethra from the start and by the time the
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Fig. 2 w hen patients were ready to leave the hospital, the infectionpresent) had progressed well toward recovery. The technic employed is as follows: The bladder is thor-oughly washed with a boracic solution and then filled with thesame before the patient is anesthetized. Nothing is inserted intothe rectum as is often done. The patient is placed in the Tren-delenburg position, a vertical or transverse incision is made, Lower—Closing the Urinary Bladder 709 depending upon whether or not there is much adipose tissue.After cutting through the sheath of the rectus and separatingthe muscle, the peritoneum is pushed out of the field and thebladder exposed extraperitoneally. A curved two pronged ten-aculum or bullet forceps catches the bladder on each side (asshown in Fig. 1), the bladder is lifted and an incision made longi-tudinally between the two tenacula into the bladder. The tenaculaare now removed and the edges of the bladder incision retracted

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