Licence: Public Domain Mark
Credit: Bladder-drainage / by John Chiene. 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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![BLADDER- DRAIN AGE By JOHir CHIENE, SURGEON, EDINBURGH ROYAL INFIRMARY. {Read before the Mcdico-Chirurgical Society of Edinburgh, November 3, 1880, and Reprinted from the Edinburgh Medical Journal for December 1880.) In August 1876 a case of perineal fistula was admitted into the clinical wards in the Royal Infirmary. A large opening, the result of sloughing, had formed in the floor of the urethra behind the scrotum, through which all the urine passed at each act of mic- turition. It was evident that a plastic operation was necessary. From previous experience in such cases, the great delav in healing seemed to me to be due to the difficulty experienced in keeping the wound dry. It a catheter is tied in the usual way, and a plug- worn, which the patient removes at each call to micturate, the result is that on the day following the .operation, during micturition, the urine passing along the sides of the catheter reaches the wound’ and interferes with, or altogether prevents union. Even if no plug is used, the urine being allowed to drip into a basin between the patient’s legs, the same result follows, to say nothing of the damp, uncomfortable condition of the bed. ~ Ihe problem seemed to be. How can the wound be kept dry for some time, and thus placed in favourable conditions for healing? Ihe method adopted, after various experiments and trials, was as follows:—A gum-elastic catheter is introduced and fixed to the penis with sticking-plaster. Care is taken that the eye of the instrument is just within the neck of the bladder. To this catheter an indiarubber tube is fixed, of sufficient length to reach without being strained over the side of the bed to the floor. It then passes into a bottle.. Ihe bottle and tube are filled with carbolized water before attaching the apparatus to the catheter. Care is taken that no air can get in at any of the joints. It is well to introduce a piece of glass tubing at a convenient part for observing the direc- uon of Um ffow. ]n order to keep the indiarubber tube steady m he bottle a piece of glass tubing is attached to its extremity, it the g ass tube extends beyond the neck of the bottle, any tolding of. the indiarubber tube at this point will be prevented. It will be evident-that a siphon action is in this way established, with](https://iiif.wellcomecollection.org/image/b22452035_0003.jp2/full/800%2C/0/default.jpg)
