The practice of surgery . Trocar puncture of the blaUil<T by the rectum. 502 EXTRAVASATION OF URINE. to what is used in ascites, directing the point of the instrument obliquelybackwards, towards the promontory of the sacrum. The canula is left,or a portion of elastic catheter, or a short lithotomy tube. And thepatient is laid on his side, so as to favor outward escape of the urine. These methods of operation have been enumerated, according to whatis conceived to be their merit. All are rare, in actual practice, and [Fig. 221.]. [Plan of the different points at which Puncture of the Blad
The practice of surgery . Trocar puncture of the blaUil<T by the rectum. 502 EXTRAVASATION OF URINE. to what is used in ascites, directing the point of the instrument obliquelybackwards, towards the promontory of the sacrum. The canula is left,or a portion of elastic catheter, or a short lithotomy tube. And thepatient is laid on his side, so as to favor outward escape of the urine. These methods of operation have been enumerated, according to whatis conceived to be their merit. All are rare, in actual practice, and [Fig. 221.]. [Plan of the different points at which Puncture of the Bladder may be performed. (Frcm Fergusson.)—Ed.] deservedly so, for none are of a favorable character. But any one ofthem is much preferable, at any time, to postponement of relief, andconsequent disaster by extravasation; and all, too, are preferable topushing a metallic catheter by sheer force through an impassablystrictured urethra. Extravasation of This may be either vesical or urethral. The Vesical, as we havealready seen, may follow wound, ulceration, or tearing of the After the wound of lithotomy, it is too common; 2. Cystitis maylead to perforating ulcer; 3. Retention of urine may be relieved onlyby a bursting of the bladder, or by a more gradual giving way byulceration. Actual laceration, however, is not uncommon, and it is notdifficult to understand why. Cohesion of the parts has been previouslydiminished, by the inflammatory process occurring in them, and, them-selves unusually lacerable, they are po
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