A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . ofresidual urine. Retention of urine is a com-paratively late symptom, butmay occur with strictures ofmoderately large calibre, espc-cially after careless instrumenta-tion, exposure to cold, or ex-cesses in alcohol. In these casesit is due to an acute congestionof the mucous membrane, whichis usually temporary. Diagnosis.—The diagnosis ofstricture is to be made onlj acareful local examination of theurethra, such examination hav-ing been suggested by almostany on
A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . ofresidual urine. Retention of urine is a com-paratively late symptom, butmay occur with strictures ofmoderately large calibre, espc-cially after careless instrumenta-tion, exposure to cold, or ex-cesses in alcohol. In these casesit is due to an acute congestionof the mucous membrane, whichis usually temporary. Diagnosis.—The diagnosis ofstricture is to be made onlj acareful local examination of theurethra, such examination hav-ing been suggested by almostany one of the above-mentionedsymptoms. It is wise to carryout such an examination in aroutine , and the followingroutine is suggested, not becauseof exceptional value, but Steel ^^^ een found valuable inSound. practice: 10 21 REFERENCE HANDBOOK OF THE MEDICAL SCIENCES. Examination should be begun witlv a sound as large asthe meatus will eomfortably admit. If this is arrested asmaller size may be tried, but stiff instruments smallerthan 18 or 20 F. cannot be regarded as safe. The pres-. FiG. 4843.—Varieties of Bougie d Boule. ence of stricture having been ascertained with the sound,examination may then be made with the bougie a boule(Fig. 4843). The larger sizes of this instrument are likelyto give confusing results, as it is difficult to distinguishphysiological from pathological narrowings. With theseinstruments it is possible to locate the position of thestricture and its size, if it will admit them at all. Thejare not of much Value in sizes smaller than No. 10 F., asthe points become engaged in small pockets in the ure- FiG. 4,44.—Gum-Elastic Bougie. thra. If sizes smaller than this are required, flexiblebougies, either of the English webbing or the Frenchmake, are most valuable. With them the presence oforganic stricture can be definitely ascertained by thepeculiar gripping sensation felt as they are being with-drawn. This sensati
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