Hematuria : a study from the practitioner's standpoint / by Victor Cox Pedersen.

  • Pedersen, Victor Cox, 1867-1958.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Hematuria : a study from the practitioner's standpoint / by Victor Cox Pedersen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    is obtained if possible. If soon after this the urine is again bloody, no differential diagnosis may be reached, as in that case the bleeding is either directly at the outlet of the pelvis or so high in the ureter as to backset into the pelvis or from the kid- ney itself. Radiography will distinguish lithiasis, and with the aid of argyrol or collargol may indicate kinks, strictures, points of pressure, de- formity, and thickening—as bleeding from the ureter proceeds from the same general conditions as elsewhere in the urogenital tract, namely, the congestion of kinks, strictures, and pressure, the special infections such as tuberculosis, the common manifestations of lithiasis, and finally primary neo- plasm. Hematuresis due to vesical conditions means, as elsewhere in the urogenital tract, change in the mucosa always circulatory and not infrequently or- ganic in character. The essential causes are the same as those previously enumerated for the kidney and ureter—namely, congestion, infectious and noninfectious inflammation, varicosities, lithiasis, papillomata, traumatism, chemical, thermal, and in- strumental (usually synonymous with and there- fore properly classified under simple inflamma- tions), ulcers, simple, tuberculous, typhoid, and cancerous, rupture by traumatism or by pathological change, as in spinal disease, and finally retention of extreme degree, which, when suddenly relieved in its entirety, not uncommonly causes hemorrhage into the bladder. It is probable that this is also one mechanical explanation of hemorrhage in hydrone- phrosis which, when at its limit, may rapidly evacuate itself and hemorrhage ensue. The pre- vious pressure on the walls produces paresis and partial occlusion, and when rapidly removed per- mits the inrush of blood to set up the hemorrhage in both bladder and hydronephrosis. A practical point, therefore, is never to draw off more than half the contents of a very full bladder at the first en- trance, so as to avoid this purely mechanical condi-