. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. as a uterinefibroid, ovarian tumor, orpelvic inflammatory disease,the treatment should bo di-rected toward the removal ofthese pathological conditions. Sixth, tho division of anybands or vessels which ob-struct the ureter. This hasalready been spoken of underheading 1. It is always per-fectly proper to cut bands,but in cutting the vessel oneshould bear in mind that thepart of the kidney suppliedwill atrophy. If the vessel issmall it is usually safe to dothis. On the other hand,when the vessel is a
. Diseases of the kidneys, ureters and bladder, with special reference to the diseases of women. as a uterinefibroid, ovarian tumor, orpelvic inflammatory disease,the treatment should bo di-rected toward the removal ofthese pathological conditions. Sixth, tho division of anybands or vessels which ob-struct the ureter. This hasalready been spoken of underheading 1. It is always per-fectly proper to cut bands,but in cutting the vessel oneshould bear in mind that thepart of the kidney suppliedwill atrophy. If the vessel issmall it is usually safe to dothis. On the other hand,when the vessel is a large oneand is, as in some instances,tho principal vessel of thokidney, such a procedure iscontraindicated. Then the proper treatment is a section of the ureter. After cutting the ureter, the in-ferior end may be anastomosed into tho renal pelvis. A method of this kindwhich allows the sparing of the part of the kidney supplied by the aberrantvessels is shown in Figiire 270. The variety of procedures of this kind whichmay bo carried out is large. In such cases very careful suturing with fine. Fig. 270.—Plastic Operation on Uretero-PelvicJunction to Relieve Hydronephrosis. In thiscase, the obstruction is due to a renal artery, plusthe descensus, as shown in a. In b, the position,extent and direction of incision are shown. Inplacing the sutures, the points a and b are broughttogether, thus making the longitudinal slit a trans-verse one. In this procedure, the renal paren-chyma supplied by supernumerary artery is spared. 552 HYDRONEPHROSIS. catgut is indispensable, and a retention catheter should always be put throughthe ureter into the pelvis and allowed to remain for some days. It can be keptclean by repeated irrigations with 1 to 1,000 formalin solution. Seventh, various plastic operations on the renal end of the ureter. Theseoperations may be done either from the outside or from the inside of the pel-vis. A few types of these operations are illustrated in Figures 270, 271, a
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