Internal urethrotomy : are the benefits to be derived from it, as now advocated for the relief of stricture, commensurate with its dangers? / by Ambrose L. Ranney.

  • Ranney, Ambrose L. (Ambrose Loomis), 1848-1905.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Internal urethrotomy : are the benefits to be derived from it, as now advocated for the relief of stricture, commensurate with its dangers? / by Ambrose L. Ranney. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    to pass an instrument through very tight strictures, attributes the accident chiefly to shock, since uraemic symptoms were absent; * but it is a question, as the instruments passed were of very small size, and therefore of necessity sharp at the point, if in at least one of the cases some injury was not done to the urethra differing but little from an incision. Within the last year I saw in consultation a case where atrophy of the penis and impotence appeared after internal urethrotomy, fol- lowed by severe haemorrhage; but I am not prepared to say that it was attributable to the operation, although no other cause could be ascertained, and the patient had, previous to the operation, been in good health, excepting in regard to the frequency of micturition, j- He has since died of renal disease. In two fatal cases reported by Bumstead,j: the strictures were situated at about four inches from the meatus, and death en- sued from septicaemia in four and fourteen days, respectively. In these cases the Otis urethrotome was employed. Dr. Brid- don § reports a case of death from internal urethrotomy, per- formed with the instrument of Maisonneuve, as a result of suppression of urine. Benal disease, however, existed prior to the operation. One of our leading surgeons lately lost a patient, in hos- pital practice, after internal urethrotomy. The details of the case have not been published. Another well-known surgeon of this city lost a patient in another hospital, after an operation with a Maisonneuve in- strument. M. G-uyon, of Paris, in the published results of internal urethrotomy in 1816, 1811, 1818, reports one case of death in a total of fifty-two cases, but he has since reported a total of two hundred and fifty cases, with seven deaths. Mr. Prescott ITewett,|| in 1863, reported a case of death from suppression of urine, following instrumental manipula- tion which drew blood. Mr. Teevan 1 reports, in 1816, three * “ Edinburgh Medical Journal,” June, 1871. f “The New York Medical Journal,” May, 1880. t Op. cit., p. 309. § “ The Medical Record,” March 6, 1880. § “The Lancet,” 1863, vol. ii. T Ibid., 1876.