Cases of vascular tumour of the urethra, with remarks / [Henry Burford Norman].

  • Norman, Henry Burford, 1819-1900.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Cases of vascular tumour of the urethra, with remarks / [Henry Burford Norman]. Source: Wellcome Collection.

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    Case VIII.1—Mr Warner relates the following interesting instance ;—iC A virgin, set. twenty-seven, had suffered from infancy from frequent desire to make water, which she voided by drops, and with excessive pain. The pain and irri¬ tation had been frequently so great, as to cause convulsions, and to prevent her from gaining her livelihood. It was much increased at the menstrual periods, especially if the customary discharge did not appear. On dilating the urethra with a female catheter, two excrescences were discovered arising opposite each other, near its hither extremity, each as large as a silver penny-piece, and re¬ sembling the valves of a vein in their situation. Their colour was red, and their texture spongy, and they consisted of a number of fibres, as appeared upon examination after their removal, which was effected bv dividing the urethra a little to its left side with a pair of scissors, and then, when the excrescences were exposed, snipping them off at their base. There was no immediate hemorrhage. Afterwards it was severe, but stopped of itself. The patient recovered without a bad symptom ; and five months afterwards she was seen by Mr Warner quite free from the disease. The same author relates the following case, in which a pediculated vascular tumour, appearing at the orifice of the urethra, was found to take its origin at the neck of the bladder. Case IX.2—A young woman strained herself by endeavouring to lift a heavy weight, and was immediately seized with pain in the small of the back, and a total suppression of urine, which lasted five days, when the catheter, had to be used. During the suppression she had an acute fever, and for eighteen or twenty hours before the water was drawn off, she discharged by mouth a great quantity of saltish water tinged with blood. Three years after this, she con¬ sulted Mr Warner. From the time of the accident she had never made water without the catheter, and on several occasions its introduction had occasioned much loss of blood. Mr Warner examined the urethra and bladder with his forefinger, which lie passed with difficulty through the canal. He dis¬ covered a considerable tumour, which seemed to be of fleshy consistence, and took its rise from the lower part of the bladder near its neck. Upon the patient’s straining to make water when the bladder was full, the tumour pro¬ truded a little from the meatus, but on ceasing to strain it presently returned. It had maintained its present appearance from the time it was first noticed, and had been punctured eighteen months before in the expectation of its containing fluid. The patient was purged, and then the following operation was performed : The tumour being made to protrude by straining, was prevented from return¬ ing by ligatures passed through its substance by the help of a crooked needle; and an effort was made to draw it down through the orifice of the urethra. This being impossible, Mr Warner divided the urethra, by cutting it upwards about half way to the bladder, and then the tumour being pulled forward, he was enabled to pass a ligature around its base, which was very large. For three days after, much pain in the abdomen was felt; on the sixth day the ligature dropped off. From the day of the operation the water was voided naturally. The tumour was about the size of a turkey’s egg. Recovery was complete. Case X.—Is recorded by the late Dr David Davis.3 A lady, fifty years of age, of firm constitution, and the mother of several children, had suffered twenty-five years from distressing pains of the urethra, and had had an excres¬ cence growing from the part all that time. It gave rise to dyspeptic symptoms, to incessant calls to empty the bladder, and occasionally to tremendous par¬ oxysms of abdominal and uterine pains, but not to any morbid secretions of the vagina. On examination of the parts, the orifice of the urethra was found 1 Warner’s Reports and Cases in Surgery, p. 309. 2 Warner, op. cit. 3 Obstetric Medicine. By David D. Davis, &c. Fourth edition, p. 80.
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