Identifier: surgeryitsprinci04keen (find matches)
Title: Surgery, its principles and practice
Year: 1906 (1900s)
Authors: Keen, William W. (William Williams), b. 1837 Da Costa, J. Chalmers (John Chalmers), 1863-1933, joint ed
Subjects: Surgery General Surgery
Publisher: Philadelphia and London : W. B. Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Fig. 297.—Wheelhouses External Urethrotomy. 574 SURGERY OF THE PENIS AND URETHRA, an effort is made to incise the urethra, the mucous coat of the canal rollsaway from the point of the knife, and the blade incises the tissue on eachside of the guide without opening the urethra; moreover, when the canalis once opened, the small hook on the end fails to hold the upper edge ofthe incision and constantly slips away, so that the canal must againbe sought for. Finally, the staff in the perineal wound is constantlyin the operators way, interfering with further manipulations. The Hor-
Text Appearing After Image:
FiG 298. -External Perineal Urethrotomy without a Guide, Employing Horwitzs Dilat-ing Urethral Staff. witz staff has the advantage not only of holding the urethra fixed, butof rendering it prominent in the perineum, so that the urethra can be in-cised with absolute precision, without loss of time, and without referenceto the anatomic landmarks, this stage of the operation being performedautomatically. Horwitz Operation.—The methotl of opening the urethra will dependon whether the canal is occluded at the bulbomembranous i unction or in the STRICTURE OF THE URETHRA. 575 membranous urethra. In the former case the urethra must be incisedbehind the stricture, whereas in the latter it must be opened in front.The perineal staff, with the blades closed, is passed into the urethra untilthe seat of obstruction is reached; the patient is then placed in the lithot-omy position, and the staff intrusted to an assistant, who is instructedto hold the beak of the instrument firmly in contact with t

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