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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    cases of death in the Hopital Necker, following internal ure tlirotomy. Lerov d’Etiolles, in reviewing Reybard’s cases, J reports having witnessed two fatal cases at the Hotel Dieu and one case of the most alarming haemorrhage, which caused, ] serious doubts as to the patient’s recovery.* Dr. Gouley re- ports a fatal case, and one in which thrombus of the iliac vein and phlegmasia dolens followed the operation of internal urethrotomy. Dr. Otis, j as before stated, reports four cas of death as occurring in his own practice. Three of the pa^ tients died on the third, sixth, and eighth days after the opera- tion, of suppression of urine and uraemia, while one died on the sixteenth day of pyelo-nephritis and renal abscess. In two of these cases, however, perineal section was combined with the use of the dilating urethrotome; so that an additional source of dano-er existed. It seems, from collected statistics, that sixty-six deaths are already verified as the result of internal urethrotomy, and that the possibility of the other dangers enumerated as liable to follow this operation is supported as well by Professor Otis's reported cases as by the opinions of those against whom the claim of prejudice might be urged. I can not refrain from j quoting the following sentence from the article of Mr. W. Mitchell Banks,£ commenting on the dangers of the use of instruments within the urethra : “ When a patient, the victim of some grievous malady which is hurrying him to certain death, prepares to submit to a hazardous operation for its re- lief, both he and the operator have weighed the chances of the operation over and over again. If the operation succeed, it is a triumph to both; if it fail, the surgeon can console himself;' with the fact that he did all that his skill enabled him to do, while he may derive, from his very failure, practical experi- ence which may guide him to happier results in the future| But it is a very different matter when a man, perhaps in the prime of life, and, with the exception of a mere local ailment, in good health, lies down upon the consulting-room sofa or the hospital bed, submits to a comparatively simple operation, has * Wade, “Ou the Treatment of Stricture,” London, 1860. f Op. til., p. 311. X “Edinburgh Medical Journal, vol xvi, 1871, p. 1078. t