. The diagnosis and treatment of diseases of women. is firmly healed. If preferred, the bladder may be emp-tied by catheter every three to six hoursfor the first two or three days, the reten-tion catheter being thus entirely dis-pensed with. With a reliable trainednurse in attendance, the frequent cathet-erization is fairly safe, but without suchan attendant, the retention catheter issafer. When it is used it should be removed and sterilized each day and thebladder washed out with boric acid solution (3%). It is well to leave the catheterout for an hour or two for a change. As long as catheter
. The diagnosis and treatment of diseases of women. is firmly healed. If preferred, the bladder may be emp-tied by catheter every three to six hoursfor the first two or three days, the reten-tion catheter being thus entirely dis-pensed with. With a reliable trainednurse in attendance, the frequent cathet-erization is fairly safe, but without suchan attendant, the retention catheter issafer. When it is used it should be removed and sterilized each day and thebladder washed out with boric acid solution (3%). It is well to leave the catheterout for an hour or two for a change. As long as catheterization is necessary, thebladder should be washed out with boric acid solution (3%) either once of twicedaily or after each catheterization. When the retention catheter is in place, thepatient may lie in the prone or semi-pione posture to favor drainage. In severecases it may be advisable to keep her in this posture most of the time, until theopening is liealed. In mild cases, no special care is necessary except to administer the urinary anti- 34. Fig. 526. The Regular Operation for Vesico-vaginal Fistula. Showing the area of Denuda-tion and also the Deep Sutures. (Montgomerj—Practical Gijnecologi/.) 516 LACERATIONS AND FISTULA septic and to see that the bladder is emptied every four to six hours, either spon-taneously or by catheter. The sutures are removed in twelve to fifteen days. Special measures. There are various special measures required by special con-ditions. In cases in which there are bands of scar-tissue in the vagina, which hold the edgesof the fistula apart, it is sometimes advantageous to divide these bands in the pre-liminary treatment, and separate the divided bands widely by a glass plug.
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