On strictures of the urethra : results of operation with the dilating urethrotome, with cases / by F.N. Otis.

  • Otis, Fessenden N. (Fessenden Nott), 1825-1900.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: On strictures of the urethra : results of operation with the dilating urethrotome, with cases / by F.N. Otis. 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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    same urethra, as reported by authorities, is, I am sure, due to an imperfect method of examination. The use of the ordi- nary sound is quite valueless in the attempt to recognize or define slight contractions of the urethral canal, which often readily dilate to its normal calibre, while they can be perfect- ly demonstrated by a bulbous sound two or three sizes smaller. I have frequently met with strictures which could not be ap- preciated during the passage of a full-sized bulb, but which, after being allowed to remain for a few moments, was percept- ibly arrested at a point of stricture on its withdrawal. I may then state it as my conviction that the bulbous sound is the only iustrumeut which can be relied upon for certain diagno- sis of strictures of large calibre. For explorations of the straight portion of'the urethra, I prefer the metallic olive- shaped sound ; for the curved portion, the olive-shaped gum bougies. (Exhibit specimens.) Contractions at the meatus, either congenital or resulting from disease, are of frequent oc- currence. Civiale recognized this fact, and is said to have “ divided the meatus in nearly three thousand cases, with the best results.” Dr. Gouley states that he has divided over two hundred. By this simple operation I have many times relieved chronic discharges and inflammatory troubles of the urethra and bladder, which had resisted every other means of relief. When such contractions exist, there can be no efficient explo- ration of the urethra previous to complete division, whether the contractions be cicatricial or congenital. Any resistance to the withdrawal of any bulbous sound which can be intro- duced through the meatus, is a positive evidence that an ab- noimal contraction is present sufficient to render nugatorv any thorough examination of the deeper portions of the ure- thra. Bearing this fact in mind, and appreciating the value ot the full-sized bulbous sound as a means of diagnosis, I be- lieve that the detection of important urethral contractions will be vastly more frequent, and that complete division of such contractions will result in the relief of much annoyance and suffering from gleet, urethral and vesical inflammation, and irritation, which cannot be permanently removed by any other means.