. Modern surgery, general and operative. Fig. 960.—Points ofGouleys whalebone guides(filiform bougies). Lr^ Fig. 961.—Gouleys tunnelled catheter threaded on a filiformbougie. it. The filiform bougie will act as a capillary drain, and in a few hours willempty the bladder and will also dilate the stricture. Then insert anotherbougie beside the first and so on for several days, using also opium, order-ing rest in bed, and making no attempt to dilate the stricture forcibly until re-tention has ceased and inflammation has subsided. Perhaps Phillipss catheter(Fig. 965) can be passed. If no instrumen
. Modern surgery, general and operative. Fig. 960.—Points ofGouleys whalebone guides(filiform bougies). Lr^ Fig. 961.—Gouleys tunnelled catheter threaded on a filiformbougie. it. The filiform bougie will act as a capillary drain, and in a few hours willempty the bladder and will also dilate the stricture. Then insert anotherbougie beside the first and so on for several days, using also opium, order-ing rest in bed, and making no attempt to dilate the stricture forcibly until re-tention has ceased and inflammation has subsided. Perhaps Phillipss catheter(Fig. 965) can be passed. If no instrument can be passed, aspirate above thepubes or perform cystotomy (suprapubic or perineal). In spasmodic stric-. FlG. 962.—A-B-E shows the proper curve (reduced in size) for unyielding male urethralinstruments; C-B-D shows an improper curve. ture hold a good-sized metal catheter firmly against the area in spasm; re-laxation will occur and the instrument will eventally pass. Fig. 962 showsthe proper curve of a metal instrument. An individual who has an organicstricture which has given but little trouble may develop attacks of re-tention because of inflammatory edema of the mucous membrane and spasmof the urethral muscles. These attacks are temporary, and an instrumentcan usually be inserted when employed as above directed. In inflammation Fic. 963.—English silk-web catheter. give a hot hip-bath and suppositories of opium and belladonna, and then usea hot sand-bag to the perineum and a hot-water bag over the these fail or if the symptoms are urgent, pass a soft catheter. In the occludedmeatus of the newborn incise with a tenotome. In a congenital cyst of the sinuspocularis pass
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