The practice of surgery . assed on, and the same effect is pro-duced—the catheters point curvinground that of the stylet, as it were. There is another peculiarity. Asthe prostate enlarges, not only is theprostatic portion of the urethra un-usually extended and curved ; it isalso very considerably enlarged, bydilatation of the prostatic sinuses oneach side of the Inretention, this dilatation is usuallyfull of urine; in fact, may be consi-dered as a small fictitious bladder infront of the real one. On the cathe-ter reaching it, a spoonful or two ofurine may be discharged, and thes
The practice of surgery . assed on, and the same effect is pro-duced—the catheters point curvinground that of the stylet, as it were. There is another peculiarity. Asthe prostate enlarges, not only is theprostatic portion of the urethra un-usually extended and curved ; it isalso very considerably enlarged, bydilatation of the prostatic sinuses oneach side of the Inretention, this dilatation is usuallyfull of urine; in fact, may be consi-dered as a small fictitious bladder infront of the real one. On the cathe-ter reaching it, a spoonful or two ofurine may be discharged, and thesurgeon may in consequence be ledto suppose, that he has reached thebladder and emptied it—the remain-ing swelling consisting of abscess;the plunge of a trocar may follow;or the patient may be left to his fate,unrelieved. But, by invariably usingthe long catheter, in such cases, andnever resting satisfied unless thisinstrument be passed tenus cupula—unless, indeed, water flow freely,-the surgeon is safe from all such. The Prostatic Catheter; of half size. without such extreme insertion-serious error. 1 Deschamps, Traitd de la Taille, torn. i. p. 200. MALIGNANT DISEASE OF THE PROSTATE. 513 Perhaps the prostatic obstruction proves insurmountable. Then thebladder must be relieved at all hazards; and one or other of the follow-ing methods may be adopted : The catheter may be forced through theobstruction; guided in a good direction by the finger in the a trocar and canula may be used instead of the catheter. Or, thebladder may be punctured above the pubes. The operation by the rectumis obviously unsuitable. Of these proceedings, perforation of the prostatic obstruction is themost advisable, by means of a suitable trocar and canula; the latter, ofthe same length and caliber as a full-sized prostatic catheter, but con-siderably less curved. It is passed carefully on to the obstruction, withits trocar withdrawn, and with its extremity temporarily occupied witha bulbous
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