Identifier: operativesurgery02brya (find matches)
Title: Operative surgery
Year: 1899 (1890s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914
Subjects: Surgery, Operative Surgery, Operative
Publisher: New York : D. Appleton and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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es the surgeonis also guided by the established re-lations of the normal urethra to thearch and rami of the pubes, to thetuberosities and rami of the ischium(Fig. 1378 and page 1182), and, stillmore important, the relations to the^ rectum. The careful cutting and Fig. 1504.—Complete rupture of urethra, searching are continued until anproximal end found Introduction of opening is found which leads intocatlieter preparatory to sewing, a. Dis- ^, , , ^ , mi x- i • ^^ tal end of rupture, h. Proximal end of the bladder. Ihe tissue barring therupture held open by forceps for intro- passage is cut, and a small gum cathe-duction of catlieter (c). d. Catheter in- : . , , ,, , ,. troduced into urethra. ter is passed along the probe or di- rector into the organ. This act isfollowed by the welcome flow of urine. The catheter is then withdrawn,the canal dilated gently, and all constricting bands at the roof and floor ofthe urethra are severed. A steel sound the size of the canal is then intro-
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()I»KI(ATI()\S ON THK SCKoITM AM) IKNIS. 12r)3 duced into the l)l;i(l(lci- tlii-(ju;,di the urttliru until its iiiiiiitcniijitfd oiitriiiicois iissiirid. Tlu si/i of tlu; im-aliis is iiicrcascd, and all ohslinatc stricturiSin front of tlic piiincal o(»tnini,f divided hy internal uretliiotoiny. Exanunethe bladder for stone, and if found remove it; stop all bleeding. In n(/)fi(rc of the lorf/ira, oecasionall) a catheter or stall may be ))assedquite reailily into the bladder. Hut in instances of complete rupture frombruising of the j)erinitMun, or incomplete rupture complicated with narrowstricture, this measure can not be uccomplished at once, if at all, especiallyin a ease of the former condition. In ruj)turcfrom bruising, a free in-cision into tlic i)erinanimis made in the medianline down upon the con-vexity of a grooved staff(page 119^), if introducedinto the bladder; if not,upon the advanced end,thus exposing the seat ofthe injury and permittingof the elimination of theblood clots

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