File:Surgery, its principles and practice (1906) (14586725900).jpg

Identifier: surgeryitsprinci04keen (find matches)
Title: Surgery, its principles and practice
Year: 1906 (1900s)
Authors: Keen, William W. (William Williams), b. 1837 Da Costa, J. Chalmers (John Chalmers), 1863-1933, joint ed
Subjects: Surgery General Surgery
Publisher: Philadelphia and London : W. B. Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Text Appearing Before Image:
C-, - Fig. 299.—Cocks External Urethrotomy. 578 SURGERY OF THE PENIS AND URETHRA, of the passage of the grooved urethral staff, so that perineal urethrotomycould readily be performed by means of the guide. When the bladder isdistended, the operation of suprapubic cystotomy is a simple procedurethat may be accomplished in about three minutes. If, on the other hand,the viscus is contracted and contains but little urine, the dissection is moredifficult, and care must be observed not to injure the peritoneum. Ifthis accident occurs, the wound should be closed immediately by a con-tinuous catgut suture, and surrounded with iodoform gauze to preventinfection. The opening in the bladder should be sufficiently large topermit the introduction of the index-finger, by means of which the vesicaloutlet is easily located, and either a silver catheter or a steel bougie is
Text Appearing After Image:
Fig. 300.—Rj;trograde Catheterization and the Location of the Posterior Limit of thk Stricture.The operator is in the act of exposing the end of the sound through a median perineal incision. passed alongside of the finger, serving to guide the beak of the instrumentinto the prostatic urethra, whence it is carried outward until the tip of theinstrument protrudes in the perineal wound; this will at once locate theproximal end of the canal. The dilating perineal staff is now passedthrough the meatus into the urethra, and carried downward until it comesin contact with the anterior portion of the stricture; the instrument infront locates the position of the urethra in front of the obstruction, whereasthe one passed through the vesical outlet into the perineum establishesthe proximal end behind the stricture. With these two landmarks show-ing the exact position of the urethra both in front of and behind the co-arctation, restoration of the continuity of the canal is easily accomplished.In

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