Cystoscopy as adjuvant in surgery : with an atlas of cystoscopic views and concomitant text for physicians and students / by O. Rumpel ; only authorized English translation by P.W. Shedd.

  • Rumpel, Oskar.
Date:
1910
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Licence: In copyright

Credit: Cystoscopy as adjuvant in surgery : with an atlas of cystoscopic views and concomitant text for physicians and students / by O. Rumpel ; only authorized English translation by P.W. Shedd. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    Cystoscopically, the congenital diverticulum is dif- ferentiated from the acquired diverticulum of the trabecular bladder by its large and circular (or ap- proximately circular) area, the acquired form present- ing commonly a smaller opening, often irregular or angular because of the trabecular folds. Further- more, a multiplicity of protrusions or eversions points rather to a genesis resulting from stagnation of urine, although, rarely, multiple congenital diverticula are on record. Fig. 7, Plate III. shows a diverticulum with sharply defined margin in the vertex of the blad- der of a prostatic patient. Its rounded anterior edge recalls the congenital form, whilst, posteriorly, an obliquely running, straight trabeculoid fold delimits the diverticular area. In the periphery of the visual field is seen at the highest point of the vesical cavity an air-bubble reflecting the arc-light of the lamp. Fig. 8 shows some particularly well-developed spiral trabeculse on the side-walls of the same bladder. Congenital anomalies of the uretral openings are of special interest, surgically. Their absence on one side or their structural imperfection, their duplication or abnormality of location lead, in certain conditions, to significant deductions in the matter of congenital de- fect or rudimentary development, of renal and uretral variation or change of position and form. However, variations of position along the urinary tract are so manifold that cystoscopic demonstration alone of de- partures from the norm in uretral location, gives no valid conclusion as to the species of abnormality present. One must postulate also that, even where the uretral entrances into the bladder are seemingly nor- mal, deviations from the natural course or structure may exist higher up. If, therefore, clinical symptoms lead to suspicion of such anomalies, e. g., of an anoma-
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