638 PARALYSIS OF THE URINARY BLADDER. 



Moussu saw such cases in dogs after injuries to the urethra. Frohner 

 improved the appearance of a horse suffering from urethral fistula 

 by performing urethrotomy at a point above the fistula where there 

 had been a dilatation of the canal. Urine was afterwards discharged 

 by the artificial opening. 



V.- PARALYSIS OF THE URINARY BLADDER (CYSTOPLEGIA). 

 CATHETERISM. 



Long-continued retention of urine, due sometimes to urethral 

 calculus, causes over-distension of the bladder, paralysis of the detrusor 

 urinse, and inability to eject the urine. 



Paralysis of the sphincter vesicae produces involuntary discharge 

 of urine (enuresis, incontinentia urinae). Not infrequently retention 

 and involuntary discharge exist together, e.g., in puerperal apoplexy, 

 influenza, &c. In diseased conditions, like post-partum paralysis, 

 hemoglobinuria, in diseases of the brain and spinal cord, and fractures 

 of the dorsal and sacral vertebra?, and after difficult parturition, 

 paralysis of the bladder may occur, and is sometimes associated 

 with paralysis of the tail and paraplegia. Calculi and gravel may also 

 produce paralysis of the urinary bladder. 



Symptoms. When the detrusor is alone paralysed, the bladder 

 gradually fills, and urine is discharged in small quantities (ischuria). 

 If paralysis of the sphincter is also present, involuntary discharge 

 occurs, the bladder overflows like an over-filled vessel, and the 

 condition is described as ischuria paradoxa. The bladder can then 

 be emptied by pressure from the rectum, or by contraction of the 

 abdominal muscles, as happens during defaecation. At each act 

 a variable quantity of urine is discharged. When the sphincter is 

 completely paralysed urine also flows away in an uninterrupted 

 stream, even when the bladder is incompletely filled (enuresis) ; 

 nevertheless, in male animals the bladder always fills to a certain 

 extent. 



The prognosis depends on the active cause. In general it is 

 the more unfavourable the longer the condition has existed without 

 visible improvement. 



Treatment. At first an attempt should be made to remove the 

 cause. Strychnine, cantharides, &c, may be given internally ; 

 when, in consequence of paralysis of the detrusor, the bladder is 

 greatly distended, it may be emptied by pressure through the rectum ; 

 or should this fail, by the catheter. 



The use of the catheter (catheterisation) calls for two precautions : 



