The importance of the post-prostatic (or trigonal) pouch in the surgery of vesical calculus : illustrated by several cases / by G. Buckston Browne.

  • Browne, G. Buckston (George Buckston), 1850-1945.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: The importance of the post-prostatic (or trigonal) pouch in the surgery of vesical calculus : illustrated by several cases / by G. Buckston Browne. 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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    —viz., that vesical calculus may exist under such conditions as to be absolutely out of the reach of all instruments in- troduced through the urethra. If time and space permitted I could give further ex- amples of a more ordinary character from my practice, where I and others have failed to find stones when sound- ing in the usual way, owing to their lying in post-prostatic pouches. In one case the bladder was opened by lateral perineal cystotomy for drainage and exploration, and the stone was not felt by the staff or detected until the finger entered the bladder; but I think enough has been related to illustrate the importance of the post-prostatic pouch in the surgery of stone in the bladder, and to prove the two propositions with which I commenced this paper. Fig. io. Bladder sound, with broad flat beak (the author’s). The practical outcome of my paper is therefore—I. The insistance in all doubtful cases of vesical suffering, where the prostate is enlarged, upon careful search being made behind that organ. In sounding in such cases it is not enough merely to reverse the beak of the sound, but thorough examination must be made, with the reversed beak, for the slit-like opening between the intra-vesical prostatic growth and the inter-ureteral ridge, which may be the sole means of access to a large post-prostatic pouch, when such a pouch exists. For this investigation a sound I have designed with a beak like a flat-bladed lithotrite will be found useful. The broad flat beak is easily re- versed when in the bladder, and it slips with greater facility than the beak of an ordinary round-ended sound
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