Bilharziosis / by Frank Cole Madden.

  • Madden, Frank Cole.
Date:
1907
Catalogue details

Licence: Public Domain Mark

Credit: Bilharziosis / by Frank Cole Madden. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    to granulate up from the bottom and from the level of the urethra. The treatment of the urethra varies with the con- dition. In some cases the mass of fibrous tissue seems to be closely incorporated with the urethral walls and an external urethrotomy must be done through this mass into the urethra and any stricture freely divided in the incision. In other cases the fistula can be traced in between the corpus spongiosum and the corpora cavernosa to the side of the urethra, where it opens laterally or even in the roof. This mass of tissue must be removed right up to the canal and the ragged opening into the urethra well scraped with a spoon and all the soft bilharzial tissue removed. Three or four days after the operation a full-sized catheter is passed and then every few days until heal- ing is complete. The large open wounds often take a considerable time to heal, but with careful packing and proper attention the result of these cases is usually very satisfactory, though repeated operations are often necessary. Sometimes an operation, similar to that for the complete removal of an elephantiasis of the scrotum, has to be performed; and in this case it is often advisable to place a drainage tube in the bladder through the urethral incision for some days to prevent any infiltration of the new scrotal wound with urine. When the urethra is very much destroyed, and there is difficulty in finding any track at all, once the remains of the canal have been found a large catheter must be tied in the bladder for a few days.