Five cases of suprapubic cystotomy : three for stone, one for tumor in the bladder, and one for exploration with catheterism of the ureters : one death / by W.W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Five cases of suprapubic cystotomy : three for stone, one for tumor in the bladder, and one for exploration with catheterism of the ureters : one death / by W.W. Keen. 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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    attacks of which were quite severe. Thinking that it might be due to the pressure of the end of the drainage- tube in the bladder, I removed this rubber tube and replaced it with a shorter tube of glass, but during yesterday, his pains being so severe, Dr. White, as I was absent from the city, removed the tube from the pre-vesical space. This was not followed by immediate relief, but with some amelioration of the attacks, and finally their disappearance at the end of about twenty-four hours. The tube in the bladder I removed to-day. His appetite is very good, so that he enjoyed a small chop yesterday and a small beefsteak to-day. His sleep has been very fair. jd (fifth day). He has had a good deal of vesical tenesmus, for which I cannot see any reason. The wound looks well. Two of the four stitches were removed to-day; some small shreds of sloughing connective tissue came away. In examining the rectum a few days ago Dr. White thought he de- tected a nipple-like prominence, just as would exist if there were a fistulous opening in the rectum, and at the operation a pouch in the posterior wall of the bladder was discovered, which possibly corre- sponds to this, although no opening or other lesion could be detected either at the operation or since. A large enema yesterday emptied the bowels thor- oughly, and there has not been, either from the bladder or from the bowels, any evidence of com- munication between the two. From this time on he improved very rapidly. His pain quickly lessened and the wound closed at the end of five weeks. Since that time he has been perfectly well. There has been no escape of faeces or of gas from the urethra, nor has there been the least return of the bleeding. The tumor was examined by Dr. J. P. Crozer Grif-