Operative gynecology : . he base of the tumor is found by a sound to be withinand attached to the bladder, instead of at the external orifice of the bladder tumor also lacks a canal. An everted ureter is attached to thebladder wall and a fine sound or catheter 1| mm. in diameter passes throughthe tumor on up over the pelvic brim into the kidney. The treatment will vary with the conditions. The cautery so often used,ought to be given up entirely for cleaner surgical methods. It is also unad-visable to transfix and ligate the protruding mass and allow it to slough away,or to cut it a
Operative gynecology : . he base of the tumor is found by a sound to be withinand attached to the bladder, instead of at the external orifice of the bladder tumor also lacks a canal. An everted ureter is attached to thebladder wall and a fine sound or catheter 1| mm. in diameter passes throughthe tumor on up over the pelvic brim into the kidney. The treatment will vary with the conditions. The cautery so often used,ought to be given up entirely for cleaner surgical methods. It is also unad-visable to transfix and ligate the protruding mass and allow it to slough away,or to cut it away beyond the ligatures, as has been done. The first and simplest plan to be tried in a recent case is reposition, aftergetting rid of the sensitiveness, either by means of a weak solution of cocainor by anesthesia. By compressing the tumor on all sides and at the same timepushing it back into the urethra a replacement may be effected which willprove permanent; the patient should be kept in bed afterwards, a vulvar com-. Fig. 234.—Hypertrophied External Ori-fice of the Urethra shown in Sagit-tal Section. Sym. is the symphysis; B, the bladder;the vagina lies below. 374 AFFECTIONS OF THE URETHRA AND BLADDER. press applied, and small doses of belladonna should be given as a sedative byrectal suppository. If the tumor can not be replaced, or if it escapes again directly after re-placement, an operation will be necessary, and the best is the excision of theprotruding portion with knife or scissors, followed by a carefully applied con-tinuous suture of fine catgut, uniting the cut edges and checking the hemor-rhage. It is important to catch both edges as they are cut, to prevent aninversion with excessive hemorrhage. DILATATION. Variations in the caliber of the urethra, both dilatation and stricture, areof infrequent occurrence. Dilatation, however, a disease never found in men,is far commoner than stricture, a disease so often found in them. Dilatation of the urethra is an enlarg
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
