A manual of minor surgery and bandaging for the use of house surgeons, dressers and junior practitioners.

  • Christopher Heath
Date:
1862
Catalogue details

Licence: Public Domain Mark

Credit: A manual of minor surgery and bandaging for the use of house surgeons, dressers and junior practitioners. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    84/256 (page 60)
    RETENTION OP URINE. Mnlarr/ed prostate gives rise to retention only in old ])Cople, and the increase in the size of the gland can be readily detected through the rectum. iSince the chief obstruction to the flow of urine is tlie central projection from the floor of the nrethra, it will be necessary to use a prostatic catheter, i. e. a large in- strument, rather longer than usual, and with a greater curve. Sliould this not pass readily, a large elastic catheter, Avithout a stilette, may be used, which will be able to dip over the obstacle. It is a great mistake to use small, short instruments in these cases, since they only perforate the prostate, giving rise to hje- morrhage, and never reach the bladder at all. JParahjfiis of the llctddcr from over-distension must not be confounded Avitli retention caused by stricture. The obvious treatment is to relieve the over-distended viscus by uieans of a large catheter; and if the house- surgeon ibllow the above rule of always beginning with a good-sized instrument, he can hardly fall into the error of making false passages in a j^reviously healthy urethra. Over-distension of the bladder gives rise also to another symptom, viz., an overflow or involuntary dribbling away of nrine; and this must not be con- founded witli the want of power over the bladder, by which the viscus is always kept empty. The diagno- sis is easily made by percussing the region of the bladder, and noticing the extent of dulness; and the rational treatment is to pass a catheter. Metention from calculus occurs usually only in chil- dren, and may often be overcome by making the child lie on its back during micturition; if this does not succeed, a catheter suited to the size of the urethra may be readily introduced. In such cases, an early opportunity should be taken to determine the presence of a stone, in order that appropriate treatment may be undertaken.