A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . be ligated or sutured lest the urineescape from the bladder and cause perito-nitis. If a patent urachus give annoyanceit may be dissected out, ligated close to thebladder, and thus excised. Displacements of the Bladder. The bladder may be inverted through theurethra, causing a red tumor with a con-stricted base, from the surface of whichmucus and urine flows. This condition isseldom seen except in children. The bladderwall, whic
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . be ligated or sutured lest the urineescape from the bladder and cause perito-nitis. If a patent urachus give annoyanceit may be dissected out, ligated close to thebladder, and thus excised. Displacements of the Bladder. The bladder may be inverted through theurethra, causing a red tumor with a con-stricted base, from the surface of whichmucus and urine flows. This condition isseldom seen except in children. The bladderwall, which has been turned inside out,should be gently reduced through the urethraby manipulation. Part of the bladder maybe contained in large scrotal or inguinal hernias. Women who haveborne children, especially if the perineum has been torn, may have thebladder sag doAvnward into the vagina and even protrude from thevaginal outlet. This condition, called cystocele, is to be treated byremoving elliptical portions of the vaginal mucous membrane over thebladder and stitching the edges of the wound so made. The perineumshould also be reconstructed by a plastic Urinal for exstrophy. Cystitis. Pathology.—Inflammation of the urinary bladder, termed cystitis,may be acute or chronic, superficial or interstitial, and may be suffi-ciently severe to result in gangrene. It is due, except in the localizedform which is the result of an aseptic wound, to bacterial colon bacillus and other pyogenic organisms, the gonococcus andthe tubercle bacillus are the usual causative agents. It appears to beestablished that cystitis does not occur in a normal bladder even whenpyogenic bacteria reach its mucous membrane, unless the normal re-sistance of the tissues has been lowered by some disturbance ofnutrition or circulation. This lowered resistance may be produced byretention of urine, calculus, enlarged prostate gland, tight urethralstricture and paraplegia. The deduction from thi
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