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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    question of reflex irritation cmd its'various manifestations. That such conditions do exist, no one at all familiar with the literature of the subject can deny, although ‘‘sexual hypochon- driasis ” may account for a large proportion of imaginary symptoms, which are to he distinguished from those due purely to reflex irritation ; but, when symptoms referred to parts dis- tant from the urethra are interpreted as dependent upon ure- thral constrictions of large caliber, not impeding the flow of urine, and are made the indication for a cutting operation which is not infrequently followed by serious complications, the advisability of such a procedure may well be questioned. Of the second series of operations reported by Dr. Otis (136 in number), 78 were performed for the cure of gleet, and 48 for the relief of reflex troubles. It may well be asked, if self- questioning is of any value in determining our actions toward others, how many of us who are here assembled would have our urethra cut for pain in the back, pubes, peringeum, rectum, or legs, until we had exhausted every other means of relief which had ever proved successful in the cure of such condi- tions ? Let us see what have been enumerated as reflex troubles in 59 cases of this character, appended to this paper,* where ac- cidents have followed the operation of internal urethrotomy : Frequent and painful micturition in 15 cases. Seminal emissions “ 4 »« Premature emissions “ 3 Neuralgic pains in distant parts “ 5 “ Imperfect erection “ 2 “ Spermatorrhoea « 1 t..lse It may not seem out of place to ask if such conditions have not frequently been seen by many of us, who have cured them by simple measures rather than by recourse to the knife. All these methods may have been tried even in these cases pre- vious to the operation, but no such statement is made, nor can I see how the cure reported of these symptoms carries any positive evidence either for or against the use of the operation in preference to other and simpler means of relief. The third proposition, which denies the possibility of cur- * As read before the Academy.