Remarks on the treatment of urethral stricture by combining internal and external urethrotomy : read before the Lancashire and Cheshire Branch of the British Medical Association / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the treatment of urethral stricture by combining internal and external urethrotomy : read before the Lancashire and Cheshire Branch of the British Medical Association / by Reginald Harrison. 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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    H without contact with urine or other possible source of irritation. If the urine be capable, as it has been suggested, of forming, under certain conditions, poisonous alkaloids, their absorption by these wounds has been rendered well nigh impossible. The urethra has been placed absolutely at I'est, and thus the process of repair has been facilitated. We have already had evidence as to the different character of the scar-tissue which is produced by this process, compared with that which follows internal urethro- tomy, where no special provision is taken to prevent the contact of stagnant urine and discharge with the healing wound. It is not difficult to imagine that the cicatrix in two instances must differ. One word before I finish, in reference to the kind of .external urethrotomy that is performed. To speak of it as a perineal section is to convey a wrong impression. It should be described as a perineal puncture with a knife, completed with a probe, along which a drainage-tube is conducted into the bladder, the process usually occupying a couple of minutes, or thereabouts. It is not necessary to introduce the finger into the l^bladder at all; in fact, this should be avoided, as it may cause a prostatitis. I operate in the following manner. The patient being placed in the lithotomy-position, and a grooved staff introduced, I punc- ture the membranous urethra with a long straight finger- knife, one inch in front of the anus, the back of the knife being towards the rectum ; the incision is slightly enlarged forwards, so as to permit the introduction of the index finger; if the staff be found exposed at the bottom of the wound, as it generally is, all well and good ; if not, I reintroduce along my finger to the bottom of the wound a somewhat blunt though pointed knife (made for the purpose), with which I clear away the few fibres that remain between the tip of the finger and the groove; if a sharp knife be thus used, either the wound is made unnecessarily large, or the finger may very easily be cut. The plan of the incision is first to make it fit the finger, and subse- quently the drainage-tube; if this be done accurately,