Atony of the bladder without obstruction or signs of organic nervous diseases / by J.W. Thomson Walker.
- Sir John Thomson-Walker
- Date:
- 1910
Licence: In copyright
Credit: Atony of the bladder without obstruction or signs of organic nervous diseases / by J.W. Thomson Walker. 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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![repeated infection by means of the catheter. All these clinical types are familiar. I mention these two preliminary groups sdl^t I may pass, with less fear of being misunderstood, to a thmd class of cases, which I now propose to discuss. Such cases have atony of the bladder, but no obstruction to the outflow, and no signs of organic nervous disease can be discovered. Let me first relate a series of cases and then discuss them. Case I.—]. M. (VI 575), a well-built man of twenty-eight years, a salesman, came under my care at St. Peter’s Hospital in July, 1909, complaining of difficult micturition and nocturnal dribbling. He first noticed difficulty in micturition five or six years before I saw him. The onset was insidious, and the trouble gradually increased. Twelve months ago, he had large steel instruments ('Vis) passed on several occasions at a general hos- pital, but without benefit. For the last six weeks his water had dribbled away at night. He usually got up twice to pass it, but if he did not wake, his bed was soaked. He denied syphilis, but stated that he had an attack of gonorrhoea seven years ago. When I examined him there was difficulty in starting micturi- tion, and he frequently waited three or four minutes. The stream was slow and there was a good deal of after-dribbling. Large metal sounds ('*/i») passed into the bladder without any diffi- culty. There was residual urine varying in amount from four to six ounces. On cystoscopy, the whole bladder showed a very pronounced degree of trabeculation (Fig. 2). There was a thick interureteric bar. The ureteric orifices were normal. The mucous membrane was clear, the blood-vessels somewhat dilated, especially at the base. The urethral orifice showed no abnormality. I could find no evidence of nervous disease, and referred him to Dr. Purves Stewart, who reported that “ his pupils, cranial nerves, sensory, motor, and reflex functions were all normal.” Case II.—G. W. B. (VII, 526), a wood machinist, aged thirty- seven, was brought to me by Dr. Robert Purdie. Fourteen years ago he began to have difficulty in passing water, and this had gradually increased. During the past four months there had been](https://iiif.wellcomecollection.org/image/b2243186x_0004.jp2/full/800%2C/0/default.jpg)
