INJURIES OP THE URETHRA. 637 



urethral calculi, because such bodies carry with them organisms 

 likely to determine decomposition of urine. Stricture is always 

 grave, especially in horses, as it becomes aggravated with time ; 

 the greater the interference with urination, the greater the danger. 

 Treatment. The chief indications are to prevent retention and 

 infiltration of urine, and to assist union. The more regularly and 

 rapidly healing proceeds, the less the chance of cicatricial contraction 

 and stricture formation. The wound is treated on general principles, 

 and protected as far as possible from discharge of urine. Clean-cut 

 wounds of the mucous membrane may be brought together with 

 catgut or silk, and in herbivora sometimes heal by first intention. 

 In carnivora it is still more important to suture the mucous membrane, 

 in order to prevent infiltration. For the same reason the skin wound 

 is best left open. Under these circumstances healing by first intention 

 occurs in exceptionally favourable cases. If not, the skin wound, 

 when not already larger than that in the mucous membrane, may be 

 increased in size. In carnivora the injured spot should be washed 

 every hour or two with an alkaline fluid (5 per cent, bicarbonate of 

 soda), or powdered with iodoform and bicarbonate of soda (equal 

 parts), and vegetable diet enforced until the wound is healed. The 

 greatest care is necessary during the first few days ; after granulations 

 have formed, infiltration of urine is less likely to occur. Injuries 

 produced by the catheter must also receive close attention. If 

 during the first twenty -four hours great swelling and retention of 

 urine result, urethrotomy or puncture of the bladder may become 

 necessary to prevent rupture. Foreign bodies should be removed 

 as soon as possible from the urethra, and the injury they may have 

 caused treated according to existing circumstances. 



When urine has infiltrated the tissues, careful provision must 

 be made for its exit, by inserting drainage-tubes. Scarification may 

 be of assistance. 



Though strictures of the urethra may be dilated by passing the 

 catheter or a bougie, and urination thus assisted, the effect is seldom 

 permanent, and the method not of much practical value. In large 

 animals it may temporarily relieve the difficulty, but new strictures 

 soon form. Strictures near the free end of the urethra may sometimes 

 be cured by freely laying them open. 



Urethral fistula is caused by an injury healing incompletely, 

 and leaving a little opening in the wall of the urethra, through which 

 urine is from time to time discharged. It may sometimes be closed 

 by applying the actual cautery ; but often it gives much trouble 

 to the practitioner, and ends by producing stricture of the urethra. 



