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.

  • Ambrose Loomis Ranney
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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    The use of the dilating urethrotome has been popularized by the. claim of its advocates that it surpasses in its results the treatment of stricture by dilatation, in the following re- spects : 1. That it accomplishes, what other operations do not, a radical cure of stricture; 2. That it relieves certain symp- toms far more effectually and rapidly than any other method of treatment; 3. That it is easily and quickly performed, when the details in the use of the instrument have been mas- tered ; 4. That it is comparatively free from danger. These points summarize, in a general way, the main arguments in its favor which the profession are asked to accept; and it is not to be denied that the propositions, as above stated, have met with a more ready acceptance than the facts, in my opin- ion, seem to warrant. Within the last few years the chief advocate of this meth- od has been able to publish between six and seven hundred operations of his own (although details were given in only 236 cases), and nearly as many more * which have been com- piled from the case-books of two or three of his supporters (Pease, Brown, and Mastin). Such an enormous number of operations—over 1,300—from so few sources, would in itself suggest that, if the operation has been justified, the general public has in the past been wofully neglected by the surgeons. But, when we take into consideration that the instrument makers are selling this in- strument to nearly every new graduate in medicine, who are often only too anxious to test its merits and equal their prede- cessors in the number of cases reported, the conservative ele- ment may well question if by its indiscriminate use surgery is not rapidly being brought into disgrace, and if those who are now the advocates of the indiscriminate use of this operation will not, in time, regret the haste with which they accepted or prejudged its merits. B. Its Elements of Danger.—Internal urethrotomy has been followed, from the statistics of collected and reported cases, by the following bad results: 1. Death from uraemia; 2. Death from pyaemia ; 3. Death from shock; 4. Infiltration of urine; 5. Peri-urethral abscess; 6. Severe haemorrhage ; 7. * Italics ray own.
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