Urethrotomy : external and internal combined, in cases of multiple and difficult stricture : with remarks on the urethral calibre / by Fessenden N. Otis.

  • Fessenden Nott Otis
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Urethrotomy : external and internal combined, in cases of multiple and difficult stricture : with remarks on the urethral calibre / by Fessenden N. Otis. 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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    Weir, Dr. Thomas T. Sabine, and Dr. Frederick D. Sturgis, of New York, and Dr. Frederic D. Lente, of Cold Spring, N. Y., with the 30 f. bulbous sound at first, and subsequently with 31 f., without being able to detect any contraction, at any point, in any one of the presenting urethrae. I am able to afford this Society further proof of the absolute absorption of the above-mentioned strictures, by presenting this case (No. III.) to you for a reexamination to-night, more than two years subsequent to the operation, in which five distinct strictures were completely divided. In the case of multiple stricture presented, it will be remembered that while 25 f. solid steel sound was easily passed through the urethra without detecting any stricture, No. 18 f. bulbous sound was arrested at the stricture-points. I propose, therefore, in order to put the crucial test to this case, to examine the urethra with No. 30 bulbous sound. This, you now observe, passes readily and easily through the urethra, and is withdrawn without the slightest retention at any point. I now pass the case over to your committee for the verifi- cation of my examination. (Drs. Post, Minor, and Woodruff, having confirmed fully the absence of stricture by introduction and withdrawal of the bulbous sound No. 30, and so reported to the Association, Dr. Otis resumed.) In order to show more fully the complete absorption of the stricture-tissue in this case, I now take a larger bulb than has at any time been used. The urethra, when free from stricture, is very distensible, and hence, by a little pressure, will admit an instrument above the normal calibre. Thus, as you see, this larger bulb, pressed firmly, not violently, against the meatus, now enters and passes without perceptible difficulty through the urethra. The size of this bulb is 34 millimetres in circumference. In closing this somewhat desultory paper, I would like to be distinctly understood as claiming, that stricture, as ordina- rily met with, is absolutely within the reach of curative measures; that, if completely divided, and this division maintained by suitable means until healing of the parts has occurred, no recontraction can ever take place; that dila- tation, temporary or permanent, is never more than a pallia- tive measure, unless carried to a point sufficient to completely rupture the stricture; that the division of stricture is not more hazardous, to say the least, than permanent dilatation—
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