Two cases of vesico-vaginal fistula / [William Keith].

  • Keith, William, 1802 or 1803-1871.
Date:
[1844?]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of vesico-vaginal fistula / [William Keith]. Source: Wellcome Collection.

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    TWO CASES 'OF VESICO-VAGINAL FISTULA. Case I_February 4, 1840.—Janet Shirress, aged 30, a widow, mother of four children, was admitted into hospital, complaining; of severe Td constant pain in the region of the bladder, and constant distillation of urine from the Yagina, along with troublesome micturition after each of her very frequent c/ills to make water. . ^ T She states that she was delivered of her first child m Soptem ^ , 1831, by the forceps, after having been in labour for forty-eight lioui^ , that for fourteen davs after, she made her water by the natural passage, when the urine began suddenly to flow through a new and artificial open¬ ing into the vagina ; and that, after a tedious illness, she recoverc health, and subsequently gave birth to three children m successive* pie - nancies, but never was able to retain her water for an instant, until the beginning of 1839, when she contrived to plug the false opening with a pint-bottlecork, after which, although a portion drained away, she enjoyed comparative comfort, and again expelled her urine by the urethra In the month of May, 1839, the cork slipped into the bladder. For some time this occasioned no uneasiness, except from the return ot U urine wholly through the false passage, but at length she became afflicted with the usual symptoms of stone in the bladder. . . As these became aggravated, she recovered the power of ret aim g her water, and this so entirely before the close of the year, that s ie ^n passed the whole of her urine by the urethra. For a fortnight past, _ irritation from the stone has become intolerable, and owing to an unceasing desire to make water, the urine drainsfoff so as to keep her constan f wet, although she still makes a portion by the natural canal.. On examination, a fistulous opening, capable of admitting a catheter, was readily detected an inch and a half behind the orifice ot 11 urethra, communicating directly with the bladder, and a stone o consi er able size was felt within that organ on sounding. February 5th.—Crushed the stone by the screw lithotnte. February 10th.—A number of fragments have come off. February 25th_Crushed three large fragments, and broke up ttie February 27 th—Portions of the cork, and quantities of debris have passed off. March 4th.—Crushed several portions of cork. , , . March 6th. — No calculous matter to be found. beized worn; remained of the cork, and withdrew it in the clawrs of the ms ru- merit* • March 7th.—Free of every symptom of stone ; but now the unne escapes wholly by the false passage* \A/,