Vesico-vaginal fistula -- spontaneous relief. "The American operation" : read before the Obstetrical Society of Boston / by B. E. Cotting.

  • Benjamin Eddy Cotting
Date:
1861
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Licence: Public Domain Mark

Credit: Vesico-vaginal fistula -- spontaneous relief. "The American operation" : read before the Obstetrical Society of Boston / by B. E. Cotting. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    0 THE BOSTON MEDICAL AND SURGICAL JOURNAL. Vol. LXIV. Thursday, July 11, 1861. No. 23. VESICO-VAGINAL FISTULA.—SPONTANEOUS RELIEF. THE AMERICAN OPERATION. [Read before the Obstetrical Society of Boston, by B. E. Cotting, M.D., Cor. Secretary of the Society.] Yesico-Yagixal fistula has been justly called a lamentable acci- dent. Its consequences are truly deplorable; the remedy difficult, and, until recently, very uncertain. Spontaneous recovery, a re- sult hardly to be hoped for, is a mere possibility. As an instance of such unexpected good fortune, the following case seems worthy of record. In January, 1844, the patient, aged 33 years, was delivered of a first child, after a labor of five days without intermission. On the third day her medical attendant left her, because she would not allow the forceps to be used. After he left, she got no at- tendance until the last moment of her labor, when she had the as- sistance of a midwife. During the five days she was not conscious of having passed any urine. Before the removal of the placenta, the water was drawn, and the catheter was used at proper inter- vals afterwards. On the third day after delivery, however, she found that she had no control over the bladder. After this, all the urine came away involuntarily and without cessation. Having been called at this stage of the case, I found a sloughy opening from the vagina into the bladder, nearly an inch above the neck of the latter, large enough to admit the tips of two fin- gers. The catheter passed readily from the bladder into the vagi- na. The nature of the case, thus clearly made out, was explained to the patient; and she was informed that, after her recovery from confinement, means for permanent relief might be tried with rea- sonable chances of success. From time to time thorough explora- tions were made ; and the case on the whole was considered a pro- mising one for a surgical operation. This was in 1844, and I was led to take this view of the mat- ter, because I had been either an observer or an assistant at most of the operations for this accident performed previously,