Identifier: textbookofgynaec00berk (find matches)
Title: A text-book of gynaecological surgery
Year: 1911 (1910s)
Authors: Berkeley, Comyns, 1865-1946 Bonney, Victor, 1872-1953
Subjects: Gynecology Genitalia, Female
Publisher: New York : Funk and Wagnalls Company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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or, betterstill, a small three-bladed urethral dilator, is inserted intothe urethral orifice and pressed against the anteriorurethral wall. This will prevent the cautery from burn-ing the anterior wall and so favouring a stricture. Theoperator or assistant then separates the labia majora,and the caruncle is very thoroughly destroyed with thepoint of the cautery, which should be heated to a dull-red colour only. Finally, vaseline is smeared over thearea of operation. (Fig. 39.) Dangers.—If the cauterization is too severe, a strictureat the orifice of the urethra may result, which, however,can be easily dealt with. Excision and cauterization or suture.—The orifice ofthe urethra is dilated as before, and the caruncle is then 87 88 GYNECOLOGICAL SURGERY seized with fine forceps and either dissected off the posteriorurethral wall with the scalpel or snipped off with a finepair of scissors ; the excision being carried somewhatwide of the growth so as to include a small piece of healthy
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Fig. 39.—Cauterization ofa urethral caruncle. mucous membrane. The rather free bleeding is then stoppedeither by cauterization or by passing a fine suture fromone cut edge of the mucous membrane through the under-lying muscle to the other cut edge and tying it.(Fig. 40.) Dressing and after - treatment. — See Chapter xxxn. URETHRAL CARUNCLE 89 Some patients after this slight operation get retentionof urine. This may last for one or two days. It can berelieved by the usual methods, and is of no seriousimportance. The patient may be allowed to get up thenext day. Recurrence.—Urethral caruncles have a marked ten-dency to recur, and in some cases more than one operation

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