. Modern surgery, general and operative. congenital cyst of the sinuspocularis pass a steel bougie, which will rupture the cyst. In complete phimosisspUt up the prepuce. In impacted stone try to pull out the calculus with urethralforceps; if this fails, cut the urethra or, in rare cases, push the stone back into Treatment of Retention of Urine 1461 the bladder. In fecal impaction scrape out the rectum with a spoon. Inenlarged prostate the rectal examination gives information as to the type ofenlargement. If there be moderate enlargement of the middle lobe the coude(Fig. 959, b) or the bicoude
. Modern surgery, general and operative. congenital cyst of the sinuspocularis pass a steel bougie, which will rupture the cyst. In complete phimosisspUt up the prepuce. In impacted stone try to pull out the calculus with urethralforceps; if this fails, cut the urethra or, in rare cases, push the stone back into Treatment of Retention of Urine 1461 the bladder. In fecal impaction scrape out the rectum with a spoon. Inenlarged prostate the rectal examination gives information as to the type ofenlargement. If there be moderate enlargement of the middle lobe the coude(Fig. 959, b) or the bicoude catheter (Fig. 959, c) will probably pass. If theseinstruments fail, try the overcurved silver catheter of Sir Benjamin metal instrument has a large curve and will probably succeed, but it isa dangerous tool and one capable of inflicting grave injury. In enlargement ofone lateral lobe with possible deflection of the urethra and valve formationtry, in order, the woven silk catheter (Fig, 963), the Nelaton catheter (Fig. 964),. Fig. 964.^Nelatons catheter. Strengthened by having a filiform passed in its lumen nearly to the beak, andthe rat-tailed silk instrument. In enlargement of both lobes and the middlelobe try the coude, then the bicoude, then a coude and a bicoude with olivaryor rat-tailed tips. If all of these fail, the overcurved metal catheter of Brodiemust be used gently. In retention from expulsive defect use a soft catheter(Fig. 964). Cases of retention after catheterization require warmth, confine-ment to bed, the administration of laxatives, free action of the .skin, and the useof such drugs as salol, boric acid, urotropin, and quinin to asepticize the urine.
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