A new method of treating strictures of the urethra, after external sections / by Claudius Henry Mastin.

  • Mastin, Claudius Henry.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A new method of treating strictures of the urethra, after external sections / by Claudius Henry Mastin. Source: Wellcome Collection.

Provider: This material has been provided by the Woodruff Health Sciences Center Library at Emory University, through the Medical Heritage Library. The original may be consulted at the Woodruff Health Sciences Center Library, Emory University.

    18/46
    Under this class of causes we are to include cystitis, hyper- trophy of the walls of the bladder, dilatation? of the ureters, disorganization of the structure of the kidney, ursemic atura- tion, etc., ing each of which such urgent constitu: distress.may occur that it will be dangerous to temporize in attempting relief by gradual dilatation of the stricture; and being unable to pass a conducting director through the coarc- tation, we are unable to do the operation of internal urethrot- omy, hence as a dernier, yet rational resort, we must perform an external section. But it must be remembered, these condi- tions are of comparatively rare occurrence; by far the great majority of strictures will admit of other means being em- ployed for their relief. In my own experience, out of a very large number of strictures which have fallen into my hands, the large majority have been treated by gradual dilatation, and successfully so. In about a hundred cases I have been induced to resort to internal urethrotomy, and in nine cases only have I found external urethrotomy requisite. But, should that rare contingency arise, should your milder measures utterly fail, should the urethra remain absolutely im- pervious—letting in no catheter, letting out no urine—then un- doubtedly, as I have stated, this condition would establish a necessity—a legitimate and imperative and urgent necessity— for your making an artificial vent for the contents of the dis- tended bladder.* Another condition is, where the urethra has given way, be- hind the seat of a stricture, and the urine at every contraction of the bladder is infiltrating the tissues, exciting them to in- .flammation and gangrene; here we are called upon to make large, free and open incisions, to evacuate effused urine; it is well in these cases to carry the knife freely through the stric- tured part, and thus open the canal to the passage of urine, as it may come from the bladder, thus insuring a cessation of in- creased infiltration, and, by a judicious operation, lay the * John Simon, F. E. S., Clinical Lecture, St. Thomas's Hospital, London, 1852.