Surgery.

Date:: [1913]

Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

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Give the Main Features of Vesical Tuberculosis. The disease is secondary to that of some other section of the genito-urinary tract, especially the epididymis and the kidney. It is most commonly found in adolescents. The leading signs are :— (a) Pyuria, containing tubercle bacilli ; they are often exceedingly difficult to detect. (b) Hemorrhage. (c) Frequent and painful micturition, the pain being referred to the end of the penis on the conclusion of the act. This symptom is especially distressing during the night. (d) Cystoscopy in the early stage may show congestion round one ureteric orifice, later, small tubercles along the line of the ureter and in late cases the , “ golf hole” ureter. The treatment is to remove the primary lesion if at all possible as the bladder condition usually heals without further surgical treatment. Describe Vesical Calculi. Oxalate or urate stones occur in acid urine, phosphatic calculi in alkaline urine. Often a stone consists of alternate strata of uric acid, calcium oxalate, and phosphates—an alternating calculus. Bladder stones are usually discoid in shape, and when multiple, present facets. Hour-glass stones stick partly in the bladder and partly in the prostatic urethra. Although vesical calculi may form at any age, they are most common in the old and in young boys. The cardinal symptoms of a vesical calculus are :— (а) Hsematuria. (б) Frequency of micturition. (c) Pain, worse after micturition, owing to the sensitive mucous membrane coming in contact with the stone. (d) Sudden stoppage of the flow of urine during micturi- tion. '