Cases of urethral stricture and their management / by James Pedersen.

  • Pedersen, James.
Date:
1904
Catalogue details

Licence: In copyright

Credit: Cases of urethral stricture and their management / by James Pedersen. 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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    normal. The urine was clear, but contained many shreds. All liability to retention having passed, the patient was sent away for two weeks with instruc- tions to use his hand-injection of bichloride, if necessary. The necessity arose but once—after ex- posure to cold and wet followed by whiskey. A mucoid discharge reappeared, but promptly dis- appeared under the injection. The urine, however, had again become clouded. As the urethra evidently was still susceptible, dilatation was postponed another fortnight. It was then begun with his own i8 F. sound, which he suc- ceeded in passing after a little manipulation under supervision. There are no skill and gentleness equal to those of the patient himself once he has practised the technique and learned the peculiarities of his urethra. In this particular case I believe it was good management, not only to let the patient make the initial attempt (under supervision), but also to allow him the instrument he was accustomed to, in spite of its caliber, which was dangerously small for use in a recently inflamed, strictured urethra. The instrumentation was followed by copious irrigation of the penile urethra from the meatus. The only reaction was a trifling increase in the discharge, which his hand-injection promptly ar- rested. At the end of a week the dilatation was carried to 20 F. Six days later, sounds 20 F and 2 2 F, were passed with the utmost care and gentle- ness. Nevertheless, a little blood appeared at the meatus. The usual after-irrigation was therefore employed. He was now free from all urethral irrita- tion and the urine had become almost clear. The stricture’s caliber having been restored to 20 F., with which the patient had always been satis- fied, he now considered himself cured and stopped treatment, contrary to advice. To explain certain details in the management of