File:A system of genito-urinary diseases, syphilology and dermatology (1893) (14577458340).jpg

Identifier: systemofgenitour01morr (find matches)
Title: A system of genito-urinary diseases, syphilology and dermatology
Year: 1893 (1890s)
Authors: Morrow, Prince A. (Prince Albert), 1846-1913, ed
Subjects: Skin Syphilis Genitourinary organs
Publisher: New York : Appleton
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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be accumulated andretained for a time in the rectum. Flatus not uncommonly escapes bythe meatus, and sometimes, though rarely and with much pain, solid fecalmatters pass out per urethram. Semen has been known to pass into therectum in a marked case of the kind. Examination per rectum will frequently reveal the posterior openingto the touch alone. With a bivalve or Sims rectal speculum and a probeit can always be found, and is usually surrounded by hard, callous folds.A metalhc sound having been introduced into the urethra, a probe ispassed into the fistulous opening as found per rectum, and the internalorifice of the fistula is decided by their meeting. In place of the soundthe endoscopic tube or urethral speculum offers great advantages when theurethra will admit them. Diagnosis follows from the above. A vesical fistula is distinguishedfrom a urethral fistula by the fact that in the former case the urine escapescontinuously from the abnormal orifice, and not alone during micturition.
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Fig. 28.—The authors long curved urethral dig:it. A, movable probe-tip for upper segment of pos-terior urethra; £, movable probe-tip for under segment of posterior urethra. Injecting colored liquids through a catheter into the bladder will alsohelp to a decision. The curved urethral digit (Fig. 28) will be of servicein detecting the locality of the urethral opening. When permissible,visual examination of the urethra is valuable. Prognosis.—This depends largely upon the cause. Those due totuberculous and cancerous processes or extensive suppuration and othergrave conditions are usually incurable. Traumatic fistulse are of betterprognosis, and have been known to close spontaneously in a few cases, Urethro-rectal fistulse are grave also in regard to the conditions thatthey cause. The irritation of the rectal and vesical mucous membraneleads to inflammatory conditions of a chronic nature in both organs. Thepatients general health may be gravely involved. Treatment.—If there be a st

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