The pathology and surgical treatment of tumors . Fig. 484. -Congenital cystic kidney, early stage(after Shattucl<). RE TEN TION- C VS TS. 693 Hydroncplirosis.—The effect of chronic obstruction to the outflowof the urine can be studied profitably in cases of stricture of theurethra or enlargement of the prostate. Dilatation of the urinarypassage occurs from the seat of obstruction and ascends progressivelythe entire length of the urinaiy apparatus. In prostatic or urethralobstruction the bladder first becomes dilated, the valves guarding theureteral orifices are rendered incompetent, the ure
The pathology and surgical treatment of tumors . Fig. 484. -Congenital cystic kidney, early stage(after Shattucl<). RE TEN TION- C VS TS. 693 Hydroncplirosis.—The effect of chronic obstruction to the outflowof the urine can be studied profitably in cases of stricture of theurethra or enlargement of the prostate. Dilatation of the urinarypassage occurs from the seat of obstruction and ascends progressivelythe entire length of the urinaiy apparatus. In prostatic or urethralobstruction the bladder first becomes dilated, the valves guarding theureteral orifices are rendered incompetent, the ureters dilate, and finallythe back pressure results in distention of the pelves of both kidneys,producing a double hydronephrosis (Fig. 485).. Fig 485.—Hydronephrosis secondary to a large calculus in the bladder; one-third natural size (afterSutton). Two fragments of calculus occupy the prostatic portion of the urethra; the left kidney was in asimilar condition. The patient, a man twenty-six years of age, died with complete suppression of urine. Unilateral hydronephrosis is the result of obstruction of the intracystic pressure often results in a localized yielding ofthe bladder-wall, sacculation, and eventually the formation of a pouch 694 PATHOLOGY AND TREATMENT OF TUMORS. which communicates with the bladder only through a very narrowopening. The presence of a stone in such a pouch frequently eludesdetection with the sound, and offers great difficulties in its removaleither by the perineal or the suprapubic route. In exceptional casesa diverticulum becomes completely detached from the bladder byobliteration of the communicating opening. Virchow saw such anisolated diverticulum in the perineum. In cases of
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectneoplas, bookyear1895
