A memoir on stricture of the urethra / by John P. Mettauer.

  • Mettauer, John Peter, 1787-1875.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: A memoir on stricture of the urethra / by John P. Mettauer. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    56 returns of the stricture, however, are not always the immediate result of the.discontinuance of the dilatation. In most cases they are gradual and slow in their return, though in some instances, they promptly reappear. incisions, formed in indurated structures, if kept from reuniting by adhesion, until they granulate and suppurate, tend to widen the contracted parts of the urethra, while the suppuration, and pres- sure of the dilating tube, or bougie, greatly promote the reabsorp- tion of tlie effused and organized lymph, constituting the indura- tion. There is r.o disposition of the urethra, to contract its cali- ber after being incised, if there is no loss of substance ; and the fears entertained-to the contrary are groundless. It is true the in- cision formed in the membranous part of the urethra in lithoto- my, is sometimes followed by contraction of that part of the canal. The contraction in this case, however, is the result of occasional ploughing taking place on the margins of the incision, induced by the extracting efforts, and not. by the incision. Any loss of substance from the mucous lining of the urethra, or from the walls exterior to it, whether from the i use of the nitrate of silver, or from ulceration, would generally be followed by more or less contraction of the canal. While wounds with loss of substance i to contract the urethra in greater or less degrees; those, with- out such loss, as uniformly widen it, especially if they heal by second intention, as will invariably be the case in the urethra, subjected, as it necessarily is, to frequent disturbance, both from the bougie,and from mining,during the after treatment of stricture. A strictured urethra, restored to its normal capacity, by the modes of treatment I have been describing, is not more liable to a return of the contraction, than any other portion of the canal which had not been its seal; provided the canal is daily dilated, l all infiamatory induration, and tenderness of the affected parts are entirely gone. ■Panchy DUalaUons posterior to the seat of stricture, occasion!? complicate permanent, stricture, and when extensive, a particular treatment will be demanded. These dilatations may be known to exist when involuntary drib- bling follows urination, especially if it take place some minutes able quantity. A close stricture, complica- ted with a pouch, or pouches, may be cured without materially affecting the pouch ; and although the water flows in a pretty bold im, mining will uniformly be followed by the troublesome and disgusting accident, of involuntary dribbling. These pouches are always to be met with on the inferior sur- of the urethra; and in a majority of cases will be situated in-