Atony of the bladder without obstruction or signs of organic nervous diseases / by J.W. Thomson Walker.

  • Thomson-Walker, J. W. (John William), 1871-1937.
Date:
1910
Catalogue details

Licence: In copyright

Credit: Atony of the bladder without obstruction or signs of organic nervous diseases / by J.W. Thomson Walker. 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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    pain. On one occasion he had passed some blood in the urine after a long bicycle ride. He had lost flesh and strength during the last 18 months. He denied venereal disease. A year before I saw him, an instru- ment had been passed at two different hospitals under the impression that there was a stricture. On examination the prostate was small and elastic, and noth- ing abnormal was detected by rectum. A large instrument was passed into the bladder without a hitch. There were 20 ounces of residual urine on one occasion and 22 on another. There was a moderate degree of trabeculation of the bladder and a small diverticulum was seen high up on the right wall. The prostate was not enlarged per rectum or intravesically. Dr. Purves Stewart reported, “ I cannot find any evidence of organic disease in his nervous system.” Case IV.—H. S. (VI, 59), aged thirty-four, complained of frequent micturition and soaking the bed at night. He gave the following history: He contracted syphilis in 1895, was treated for two years. He first noticed difficulty in micturition and increased frequency in 1898. The frequency amounted to six or eight times during the day and not at all at night, and this increased during these years to half-hourly frequency during the day and once at night. There was a difficulty in starting, and the patient had to wait some minutes before the flow com- menced. He was admitted to St. Peter’s Hospital in 1901 with these symptoms. The stream was intermittent and there was after-dribbling. Occasionally he had to go to stool to get the water to pass. No stricture was found, there was no residual urine, and the bladder, examined by the cystoscope, was healthy. “ The cut off muscle was divided ” by the surgeon in charge of the case and the patient was said to be relieved. When I saw him in 1910, he still complained of difficulty in starting micturition and straining during the act. The flow was intermittent. It commenced with fair force, but gradually fell away into a dribble. When the bladder was full and he lifted a heavy weight or coughed, a little urine escaped; there was a slight escape from the rectum also at any undue muscular exer- tion. He had passed urine every hour and a half to two hours and had soaked the bed at night for the past 12 months. The prostate was not enlarged by rectum. The urethra admitted the