Surgical Cases, from the Records of the City Hospital, Boston

David W. Cheever
1865 Boston Medical and Surgical Journal  
one of the Visiting Surgeons. [Communicated for the Huston Medical and Surgical Journal.] Fiflh Paper.-Foun Cases op Extravasation op Urine and Pbbinbal Section. Case I.-Impermeable Stricture ; Perinea! Section, ; Recovery.-(Under the care of Dr. Cheevcr.)-May 18th, 18G5. T. L., »t 23, had syphilis a year ago, and no treatment ; has lost a good part of the glans penis, and for ten months past has been troubled with a stoppage of urine, every few weeks, increasing in frequency and severity. Now,
more » ... and severity. Now, has passed no water for thirty hours ; suffers great pain ; cannot stand still a moment. Prepuce found adherent to glans penis" and a very contracted meatus. Smallest size clastic catheter got into bladder, but no uriuc passed. At 9, P.M., I was called to him and tapped him through the rectum. For tho next few days the valvular opening in the rectum relieved the over distension and spasm, and somo urine passed by the urethra. No instrument could be got into the bladder. On the 24th, a capillary bougie was got a little way into the urethra. The patient being etherized and put in proper position, an incision an inch aud a half long was mado in tho perinoeum, and fortunately soon reached the end of the bougie. Tho urethra being opened, a large catheter was readily passed into the bladder. A smaller silver catheter was now attempted to bo passed upwards, but camo out in the glans at the side of tho meatus. This was found to bo a cartilaginous and rigid false passage, and any further effort was desisted from. A female silver catheter was put into the bladder through the perinoeum, and a small elastic one fastened into the upper portion of the urethra. Pour days later, a larger bougie could be got through the vias naturales. This was followed up day by day until, on June 5th, a No. 5 silver catheter was entered at the meatus, and passed through the entire urethra into the bladder and left in.
doi:10.1056/nejm186510260731301 fatcat:2ewdwekfpvekbh2lbzwr3pi7e4