Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . Bland-Sutton removedthe upper third of the bladderon one occasion. The woundwas closed, and the bladderdrained with a self-retainingcatheter for ten days. Threeyears later it was found thatthe bladder could hold 15ounces of urine. The signifi-cance of a wounded bladder isfar otherwise if the accidentremains undiscovered at thetime of operation, since it maythen lead to extravasation ofurine with fatal results. Figure 130 shows a draw-ing made from a specimen inmy museum. It represen
Fibroids and allied tumours (myoma and adenomyoma) : their pathology, clinical features and surgical treatment . Bland-Sutton removedthe upper third of the bladderon one occasion. The woundwas closed, and the bladderdrained with a self-retainingcatheter for ten days. Threeyears later it was found thatthe bladder could hold 15ounces of urine. The signifi-cance of a wounded bladder isfar otherwise if the accidentremains undiscovered at thetime of operation, since it maythen lead to extravasation ofurine with fatal results. Figure 130 shows a draw-ing made from a specimen inmy museum. It represents theureters and a portion of thebladder-wall. The right ducthas been tied and the adjacentvesical wall perforated. The accident happened dur-ing the removal of the largecomplicated tumour seen inFigure 102, page 89, by blindligation of the right uterine artery. A blunt pedicle-needle carrying stout silk was passed deep into the pelvisbetween the impacted tumour and the bony pelvic doubt the ureter was felt, and taken by the operator forthe uterine artery ; then, probably wishing to tie the vessel. 130.—Showing the right ureter tiedduring operation, and a perforation inthe bladder-wall which was only dis-covered at the autopsy. The ureter isdistended above the ligature. 122 BLADDER, URETERS, PELVIC COLON chap. as far out as possible, the blunt point of the instrumentwas carried forwards and pushed through the corner of thebladder. Extravasation of urine followed, leading to generalsloughing of the pelvic cellular tissues. At the autopsy theseptic track was found to have spread up to the umbilicus,along the cellular space in which the urachus is situated. John Bland-Sutton, in large print, makes the state-ment that the bladder and ureters are more often injuredin the removal of mesometric fibroids than in any otherpelvic operation. This is not the experience of thoseoperators who undertake to carry out Wertheims techniquefor cancer of the cervix. Although cystitis is
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecologyoperative
