Operative surgery . meet the contingency. Vigorous tractionon the short axis of a long stone pulls the bladder downward so as to exposethe prostate at the perineal wound if continued. Lateral movements withtraction, when slowly made, will facilitate the removal of a calculus withoutcontributive danger. If a stone be too large for safe removal it should becrushed and removed piecemeal. The Complications.—The complications can be rationally divided intothe concomitant and consequent varieties. A deep perinteuni due to corpulency, enlargement of the prostate, thepresence of tumors in the bladder,
Operative surgery . meet the contingency. Vigorous tractionon the short axis of a long stone pulls the bladder downward so as to exposethe prostate at the perineal wound if continued. Lateral movements withtraction, when slowly made, will facilitate the removal of a calculus withoutcontributive danger. If a stone be too large for safe removal it should becrushed and removed piecemeal. The Complications.—The complications can be rationally divided intothe concomitant and consequent varieties. A deep perinteuni due to corpulency, enlargement of the prostate, thepresence of tumors in the bladder, and post-prostatic encystment of thestone, preventing the grasping of the calculus, are not infrequent concomi-tant complications. Among the consequent co^nplications are wounding of the bulb, the rec-tum, or the bladder. The latter viscus may be severely wounded by punc-ture with the staff, the slipping of the knife from the groove, etc. Lapa-rotomy and closure of the wound should be promptly practiced in those. cases. If the incision be carried too far inward or outward the rectum orthe pudic artery may be cut respectively, and if begun too far from theanus or at the median line the bulb will suffer. If the penis be drawn for-ward on the staff, and the staff be raised against the pubic arch as theurethra is being opened and the incision extended, the bulb is drawn awayfrom the course of the knife. Breaking of the stone seems a trivial compli-cation, but may be very annoying before the fragments are all inability to find the stone after making the incision is perplexing, whichmay depend on a false passage, a hidden calculus or its unobserved escapewith the first gush of urine, or possibly on a mistaken diagnosis. Inconti-nence and retention sometimes occur. Hfemorrhage at the time, or shortlyafter the operation, is a troublesome and sometimes fatal complication. Ifarterial hnemorrhage occur, catch and tie the bleeding point if practicable ;the bleeding may be ch
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