1899 Journal of the American Medical Association  
ary or fecal leakage; in both, however, there were evi¬ dences of septic peritonitis, caused no doubt by infection from the bowel during the course of the operation; in the dog that survived thirty-six hours there were also evidences of a very intense hyperemia of the kidneys. I am fully convinced that the operation is much more simple in the human subject and less likely to be followed by septic infection, as contamination from the bladder or bowel can be much more efficiently guarded
more » ... ly guarded againstespecially if the sigmoid mesocolon is long enough to permit the bowel to be dragged out of the median in¬ cision. T would summarize my impressions as follows : 1. All autoplastic methods proposed for the cure of exstrophy of the bladder are unsatisfactory and, at best, simply palliative. 2. Of all the radical methods which involve an ex¬ cision of the bladder and a transplantation of the ureters to the rectum, Maydl's operation is by far the most com¬ plete, rational and satisfactory, from the technical point of view. 3. Mayell's operation offers the best conditions for the complete correction of the associate epispadias. 4. Notwithstanding the comparatively large number of successful cases accredited to this method, its relation is not yet fully ascertained, though the ratio, as obtained from published cases-over 13 per cent.-establishes the superiority of this method above all others from the prog¬ nostic point of view. 5. Notwithstanding the apparent theoretic simplicity of its technic, Maydl's operation is a difficult, laborious, and in many respects a dangerous, operation anfl should
doi:10.1001/jama.1899.92450570016002e fatcat:5w6zqgz2f5fmpnd25ddxnirhkq