. Modern surgery, general and operative. nattempting micturition, while in the latter it is extensive and does enlarge onattempting to pass water. Furthermore, contusion does not cause urethralhemorrhage, while rupture does. A contusion sometimes, but not often, preventsthe passage of a catheter; a rupture almost always, but not invariably, does mortality from severe rupture with extravasation is about 14 per cent.(Kaufman). Treatment.—In some very rare cases it is possible to suture the urethra, andthis procedure should be carried out when possible. In order to suture, per-form suprapu
. Modern surgery, general and operative. nattempting micturition, while in the latter it is extensive and does enlarge onattempting to pass water. Furthermore, contusion does not cause urethralhemorrhage, while rupture does. A contusion sometimes, but not often, preventsthe passage of a catheter; a rupture almost always, but not invariably, does mortality from severe rupture with extravasation is about 14 per cent.(Kaufman). Treatment.—In some very rare cases it is possible to suture the urethra, andthis procedure should be carried out when possible. In order to suture, per-form suprapubic cystotomy and also make a perineal section. Find the pos-terior end of the ruptured urethra in the perineum by passing a catheter fromthe bladder into the urethra. Suture by way of the perineum and with sutures pass through all of the coats of the urethra. The roof of the canalis sutured first, then a steel sound is introduced from the meatus, and theurethra is sutured around the instrument. The sound is withdrawn and the. Fig. -Rupture of the urethra and extravasationof urine. Symptoms and Treatment of Foreign Bodies in the Urethra 1489 bladder is drained by Cathcarts siphon as illustrated in Fig. 968 or by a doubletube. In recent cases of ruptured urethra the usual treatment is as follows:Immediately perform median perineal section and turn out the clot; trim offlacerated edges; find the proximal end of the urethra, pass a catheter from themeatus into the bladder, and leave it in situ until healing has begun aroundit. If the catheter cannot be passed from the meatus, open the bladder abovethe pubes and find the proximal end of the torn urethra by retrograde cathe-terization. In retrograde catheterization we push an instrument from thebladder into the wound and use it to guide a catheter from the meatus intothe bladder. When rupture occurs back of a stricture it is a good plan to excisethe cicatricial tissue. In cases with extravasation make a median incis
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