File:Clinical lectures on stricture of the urethra and enlargement of the prostate (1901) (14597831927).jpg

Identifier: clinicallectures1901frey (find matches)
Title: Clinical lectures on stricture of the urethra and enlargement of the prostate
Year: 1901 (1900s)
Authors: Freyer, P. J. (Peter Johnston), Sir, 1851-1921
Subjects: Prostate Prostate Urethra Urethra Urethra Prostate
Publisher: New York : William Wood & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
atation. As, however, the vast majority of thesecases are now best dealt with by internal urethrotomy, Symesoperation has lost its raison detre, and is practically obsolete. External urethrotomy on a staff previously passed throughthe stricture is now only employed for cases complicated withbad urinary fistulae, or when drainage of the bladder throughthe perineum is necessary. 62 OPERATIVE TREATMENT OF STRICTURE Authors Operation. The following is the method of performing external ure-throtomy which I myself practise when the stricture is tra-versable by an instrument. The patient being anaesthetized and placed in the lithotomyposition, if the stricture be a tight one I commence by intro-ducing a flexible filiform guide, on to which is screwed a fineconical steel dilator (Fig. 15), No. 2 English scale. This ispassed on after the guide, which curls up in the bladder.The steel dilator is then withdrawn and unscrewed, the guidebeing left in the stricture. The next larger-sized dilator is
Text Appearing After Image:
Fig. 27. screwed on, and passed as before; and so on, rapidly dilatingthe stricture till a fairly large-sized dilator—say, 6 or 8 E.—is reached, when the staff (Fig. 27) is screwed on to the guideand introduced into the bladder. These staffs I had specially constructed with a short curveand tapering beak, a female screw being drilled in the end forthe reception of the male screw of the guide. If the stricture admit a fairly large staff without dilatationthe above preliminaries are, of course, unnecessary, and thestaff is passed forthwith. An incision a couple of inches long is then made in themedian raphe over the site of the stricture and the dissectionrapidly carried down through the perineum as far as the staff,and the stricture divided freely. The fistulse are scraped, and OPERATIVE TREATMENT OF STRICTURE 63 all sinuses that communicate are laid open, their marginsbeing scraped, or clipped off with scissors if ragged and un-healthy. A blunt gorget is then passed along the groo

Note About Images