Proceedings of the Philadelphia County Medical Society - Vol.8 (Session of 1887).
- Philadelphia County Medical Society
- Date:
- 1888
Licence: Public Domain Mark
Credit: Proceedings of the Philadelphia County Medical Society - Vol.8 (Session of 1887). Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![A SUCCESSFUL CYSTOTOMY AFTER FAILURE OF SUCTION TO REMOVE A PIECE OF A CATHETER FROM THE BLADDER. By W. W. KEEN, M.D., PROFESSOR OF SURGERY AT THE WOMAN’S MEDICAL COLLEGE OF PENNSYLVANIA ; SURGEON TO ST. MARY’S HOSPITAL, ETC. [Read December 28, 1887.] The recent suggestion of Dr. De Forest Willard (The Medical News, November 26, 1887) and Reginald Harrison (Lancet, Oct. 29, 1887), to extract foreign bodies from the bladder by the rubber bulb and evacuator of Bigelow’s litholapaxy instrument, makes a valuable addition to our surgical resources in these troublesome cases, and is my especial reason for bringing to your attention to-night the following case. The failure of the method in this particular instance was due to special reasons. J. W., a healthy man, aged seventy-five years, living in Elkton, Md., had suffered for a considerable time with recurring retention of urine, and cystitis following an enlarged prostate. Dr. Charles M. Ellis, his attending surgeon, very wisely taught him the use of the catheter, which he has employed daily for some months. The N61aton catheter (No. 22 French), which he has employed, having lost its rigidity, he whittled a pine stick to the necessary size, and sought, by means of this, to introduce it into the bladder, November 7, 1887. In the attempt the catheter broke, and a piece, subsequently ascer- tained to be 41 inches long, broke off and passed into the bladder. Severe pain and retention followed immediately, and persisted until after I operated upon him. Dr. Ellis, having failed in his efforts to extract the fragment, sent him to me, as the surroundings at his home were most unfavorable for any operation. Three days after the accident I made repeated unsuccessful efforts at extraction with forceps and lithotrites. I was not even able to detect the fragment. On November 11th and 13th I attempted to remove it by suction with Bige- low’s evacuator. On the last occasion Dr. Willard kindly helped me person- ally. We repeatedly filled the bladder with warm boiled water, being careful to keep the extremity of the evacuating tube just at the vesical extremity of the](https://iiif.wellcomecollection.org/image/b28039117_0314.jp2/full/800%2C/0/default.jpg)
