File:Virginia medical semi-monthly (1916) (14788694763).jpg

Identifier: virginiamedicals2119unse (find matches)
Title: Virginia medical semi-monthly
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: Richmond, Va. : (L. B. Edwards)
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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grains, and urotropin, fifteen grains, three timesa day. Exhibit C.—Actual size photograph of the middle lobewhich was removed. This measures one inchlong, one-half inch lateral diameter, and three-eighths inch antero-posterior diameter. His urine and heart were normal. October 18th. Cystoscopic examination at-tempted but failed on account of the lengthof the urethra and the position of the enlarge-ment. Could not get the instrument in farenough to get a clear view. A catheter was left in the urethra for fourdays and bladder irrigated daily. Catheterremoved on the fifth day and patient voidedeasily for about ten hours when he had anotherattack of acute retention. October 23rd. Phenol-sulphone-phthaleintest, intravenous injection, showed 65 per cent,elimination during first hour and 30 per cent,the second. Blood pressure 150 systolic.Urinary output good. October 25th. Operation. Made the usualsuprapubic incision into the bladder and foundthe middle lobe of the prostrate projecting up
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138 THE VIRGINIA MEDICAL SEMI-MONTHLY. (June 23, from behind the internal meatus, acting as aball valve when the patient attempted tourinate. See Exhibits A, B and C. This wasenucleated and the cavity packed with gauzeon account of the hemorrhage. The gauzewas held in place by two plain catgut sutures.One large rubber drainage tube was left in thesuprapubic opening. The tube was held inplace by a purse string suture in the bladderwall and an anchor stitch through the skin,and was long enough to reach a bottle underthe side of the bed. The distal end of the tubewas kt pt under fluid in the bottle, therebyacting as a syphon. As suggested by Deaver,no irrigation was used until after the removalof the tube which was done on the fifth day.After this the bladder was irrigated once dailythrough the urethra and suprapubic opening.No instrument has been passed in the urethrasince the operation, the irrigation being forcedthrough by gravity. He made an uneventful recovery and has agood function

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