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.

    9/28 (page 9)
    than by those previously existing. I can not, however, refrain from quoting the following passage from a work which has lately appeared,* with which I am in the fullest accord : “ I have raised my voice for what it may be worth in protest against the views of the new school in urethral pathology, which seems to claim that every natural undulation in the tis- sues of the pendulous urethra is a stricture fit for cutting, and that all the ills of the genito-urinary passages may be ac- counted for by the existence of these undulations, and usually made to disappear when the latter are cut. The theories of the new school are as ingeniously perfect as the instruments which carry them out; but, unfortunately, its claims seem to leave out of view that the disease for which the patient seeks relief is only a symptom; and that such symptoms may be due to a variety of causes. What will cure a symptom in one case, will not necessarily do so in another. And a serious criticism upon the methods of the new school is that it does not gener- ally, in its list of published cases, give any prominence to those cases which have been cut without relief \ of the symptoms complained of.” I can not myself agree with the advocates of this school that a meatus which is not accompanied by pockets on the upper or lower wall of the urethra should ever be divided to permit the introduction of instruments which shall correspond in point of size with the somewhat arbitrary measurement of the capacity of any individual urethra ; nor have I ever been convinced that a radical cure of the stricture is always in- sured by the urethrotome, or that the symptoms do not, in a certain proportion of cases, remain after the operation, unless treatment by other methods is used in conjunction. Unless these two latter tenets can be fully maintained, the urethro- tome must be considered as capable of being judiciously used only in a somewhat restricted number of cases. The chief ad- vocate of this operation has himself, I think, met with a few cases in latter years where his operation (performed by him- self) has been followed by a return of the stricture ; and many wheie certain symptoms for which the operation was performed were not relieved. * Keyes, op. cit.