Urethrotomy : external and internal combined, in cases of multiple and difficult stricture : with remarks on the urethral calibre / by Fessenden N. Otis.

  • Otis, Fessenden N. (Fessenden Nott), 1825-1900.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Urethrotomy : external and internal combined, in cases of multiple and difficult stricture : with remarks on the urethral calibre / by Fessenden N. Otis. 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.

    22/26 (page 20)
    <w protects the urethra from injury, and prevents the access of the urethral secretions to the interior of the instrument. When introduced into the ure- thra and expanded up to a point which is recog- nized by the patient as filling it completely—and yet is easily moved back and forth—the index at the handle will then show the-normal circumfei- ence of the urethra under examination. In with- drawing the instrument, contractions at any point may be exactly measured and any want of corre- spondence between the calibre of the canal and the external orifice be readily appreciated. Among the advantages to be claimed for this instrument are: 1. Its capacity to measure the size of the ure- thra and to ascertain the locality and size of any strictures present, without reference to the size of the meatus. 2. It enables the surgeon to complete the examination of several presenting strictures by a single introduction of the instrument, and by reduction of its size avoid the irritation which usu- ally attends the withdrawal of the ordinary bougie or bulbous sound. Returning to the case of aggravated multiple stricture above related, it will have been observed that, notwithstanding the easy passage of a Ho. 31 solid steel sound, through the entire urethra, after the operation, there was an immediate tendency to recontraction / that within a comparatively short period, the presence of stricture was again definitely recognized. I do not call your attention to this important fact on account of its novelty, for every surgeon of experience has too frequently observed it; and every writer on stricture has recorded it in terms the most emphatic; some even going so far as to state, as does Mr. Wade1 (quoting the illustrious Dupuytren), that, “ what- ever care may be taken in the dilatation of strictures, the dila- tation is but temporary in the greatest number of persons, and the contraction has always a tendency to return.” Sir Benja- min Brodie says (op. cit.): “ After a patient has conceived 1 Wade on “Stricture of tlie Urethra,” London, 1860, p, 352. Urethra-metre.