Operative gynecology : . examining thepatient, who was twenty-eight years old, he found a large stone 2 by 2-J by 1|inches in diameter in the bladder; she would not allow any cutting operationto be done, so he caught the stone with a pair of forceps introduced throughthe urethra, and deliveredit slowly by traction. Theexternal meatus was themost resistant portion, buthe succeeded in working itthrough in about three-quarters of an hour, bypressing back the tissuesover the stone much as anobstetrician may try to helpthe perineum back over theadvancing head of the stone was rough on one
Operative gynecology : . examining thepatient, who was twenty-eight years old, he found a large stone 2 by 2-J by 1|inches in diameter in the bladder; she would not allow any cutting operationto be done, so he caught the stone with a pair of forceps introduced throughthe urethra, and deliveredit slowly by traction. Theexternal meatus was themost resistant portion, buthe succeeded in working itthrough in about three-quarters of an hour, bypressing back the tissuesover the stone much as anobstetrician may try to helpthe perineum back over theadvancing head of the stone was rough on oneside and tore the mucousmembrane of the canal con-siderably ; this produced asharp venous hemorrhage ofshort duration. In spite ofthis enormous dilatation,she suffered no serious in-convenience, although un-able to hold her water aslong as before. 2. The vaginal inci-sion is to be preferred for stones which are so large that they can notsafely be removed through the urethra, and is adapted to all but the Fig. 245.—Removal of a Calculus through a Vaginal In-cision MADE FROM THE CERVIX UTERI TO THE TRIGONUM Vessels. The method of making the incision is described on p. 412.(Sanger, March 20, 1899.) Natural size. 412 AFFECTIONS OF THE URETHRA AND BLADDER. The operation is best conducted with the patient lying in the left semi-prone position, with the posterior vaginal wall well retracted, so as to exposeclearly the entire extent of the anterior wall from cervix to urethra. A bluntinstrument like a male sound is now introduced through the urethra into thebladder, and the vaginal wall is pushed forward in the median line and cutthrough, opening the. bladder; the incision is now extended by drawing apartthe edees of the wound and cutting; back toward the cervix and forward towardthe neck of the bladder until it is large enough to permit the introduction of theblades of a pair of stone forceps, which are used to grasp the stone by its small-est diameter and draw it o
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
