A case of large secondary prostatic calculus, removed by perinæal incision / by T. Herbert Barker.

  • Barker, T. Herbert (Thomas Herbert), 1814-1865.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: A case of large secondary prostatic calculus, removed by perinæal incision / by T. Herbert Barker. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    10/12 (page 10)
    of the urethra, reference could not be found to any case in whicli the calculi presented the same characters as the one which has been described. Somewhat similar cases, as far as the situation of the calculus is concerned, are detailed in pages 26, 27, 29, and 30 of that treatise, and the practical and experienced author strongly recommends the removal of the calculus thus placed by a lateral incision in the perinseum, where a stafi can be introduced into the bladder, or by cutting upon the gripe, where it cannot. In the following foot-note of page 27, cases are alluded to particularly bearing upon the mode of treatment adopted in the one just now described. In Essaijs and Observations, Physical and Literary, vol. iii., p. 546, published by the Philosophical Society of Edinburgh, Dr. Livington has related two cases of vesico-urethral calculus; in one the calculus was found post-mortem, in the other he operated by cutting on the gripe. The difficulties attending such an operation, where you propose to operate and cannot get a staff into the bladder, are shown in Medical Facts, vol. viii., p. 126; also in an interesting case by Mr. Cheston, of Gloucester, related in the Medical Records and Researches, vol. i., p. 163. Under complete retention of uriiTC, with a stone thus lodged, or a small stone impacted in the commencement of the urethra, the sm-geon, being unable to get either catheter or staff into the bladder, may be compelled to cut into the urethra at its membranous part, and to incise the neck of the bladder, in order to give outlet to the urine, and at the same time to remove the calculus. I have met with examples of such practice being required. M. Deschamp removed a calculus, situated in the prostatic urethra and causing complete retention, by an incision, as in the lateral operation of cystotomy. [Traite de la Taille, tom iv.) Sabatiei', [Med. Operatoirc, tom iii., p. 136,) observes that the Celsiau method is preferable to all others when the stone, having lodged at the neck of the bladder, has gone on increasing so as to extend into the urethra and become prominent in the perinseum; and Dionis, [Operations de Chirurgie, par La Faye, p. 221,) previously made the very same remark. This being an unusual case, not only from the fact of so large a calculus lodged and increasing in the prostatic urethra having been removed by operation, but from the mechanical structure and