. Annals of surgery . eralcatheter, resulting later in its passage, has removed from the field of operativesurgery about one-half the cases of ureteral stone and represents a greatadvance in treatment. The size of the stones sometimes made to pass bythis method is quite surprising. But theremarkable success obtained does not meanthat this method is always indicated or thateven its trial is always justified. If attemptedin cases not suitable for it. it may do harmand will in any such case put the patientthriiugh an unnecessary amount of disconi-lort. Brfiasch ( Alayo Clinic, vol. xi, 1919,]). 2
. Annals of surgery . eralcatheter, resulting later in its passage, has removed from the field of operativesurgery about one-half the cases of ureteral stone and represents a greatadvance in treatment. The size of the stones sometimes made to pass bythis method is quite surprising. But theremarkable success obtained does not meanthat this method is always indicated or thateven its trial is always justified. If attemptedin cases not suitable for it. it may do harmand will in any such case put the patientthriiugh an unnecessary amount of disconi-lort. Brfiasch ( Alayo Clinic, vol. xi, 1919,]). 267) says that when a stone has beenludtied in the lower ureter I rum three to sixmnnths, or is more than _ cm. in diameter,the possibility of dislodgement with thecatheter is greatly diminished. Where thereis a serious infectidii of the ureter or kid-nev, I think the method should not be , in the majority of cases, if thestone is nut too large and the evidence ofinfection slight, several attempts should be. 1 Hospital. Fig. s.—S. D., 752. 1923- Ureteral stcby extraperitoneal ureterotomy April No sutures, some drainage buturinary leakage questionable. Kidney stoneremoved by enlarged pyelotomy April 24,1923. No sutures. Discharge had urin-ary odor for three days, requirmg change niade to dislodge the stoue. I f these attempts but once a day. ^ are followed by much reaction they should betliscontinued and the stone removed by operation. If the stone is not toolarge to pass and its arrest in the lower ureter of short duration, neitherdislodgement nor operation should be done, but a reasonable chance given it topass. The drinking of large quantities of water will undoubtedly facilitateits passage. In endea\oring to decide between dislodgement with the catheter andoperation, one (jf the factors to be considered is experience. I would preferthe operation in experienced hands rather than dislodgement l)y an inexperi-enced cystoscopist, and the dislo
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
