Inflammation of the bladder and urinary fever / by C. Mansell Moullin.

  • Mansell-Moullin, C. W. (Charles William), 1851-1940.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Inflammation of the bladder and urinary fever / by C. Mansell Moullin. Source: Wellcome Collection.

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    the bladder, it causes exceedingly little inconvenience. The patient can even move about in his room. And if the eye is only just inside the bladder, it drains it fairly well. The urine should flow from the catheter drop by drop, without any break. If, when the catheter is moved either backwards or forwards, a small stream flows out, the eye of the catheter is in the wrong place, and the drainage is imperfect. On the other hand, it has a great many drawbacks. It does not answer when there is a large flaccid bladder, or in cases in which there is a thin-walled post-prostatic pouch, and these are often the ones that need drainage most. The walls of the bladder collapse and fall together, instead of contracting uniformly towards the orifice, and the recesses remain undrained. Inflammation of the urethra is not uncommon if the catheter is kept in more than a day or two, even though the surface is perfectly smooth and it is changed sufficiently often ; and the in- flammation may spread to the bladder itself, or to the epididymis, or to the veins that form the prostatic plexus. In other cases the kidneys resent it. I have known on several occasions suppression of urine caused by tying a catheter into the urethra, in women as well as in men; and I have known it continue until the catheter was withdrawn. In short it is only in comparatively slight cases, in which the wall of the bladder is but little affected, and the kidneys are still sound, that this method of drainage can be regarded as safe or efficient. In those cases that need it most, it often fails to keep the bladder empty, and it is always attended by a considerable amount of risk. The bladder may be drained with greater certainty through an artificial opening. This may be made either over the pubes, in the perineum, or (in the female sex) through the vesico-vaginal septum. Supra-pubic drainage. At first sight an incision into the front wall of the bladder, over the pubes, appears to be