URETHROTOMY. 



563 



Fig. 470.— Secure for Ischial Urethrotomy. 



ward, as may be required, with the bistoury, guided by the 

 grooved director, a blunt bistoury being sometimes chosen from 

 the motive of prudence, in order to avoid possible injury to the 

 surrounding blood vessels. 



In our experience we have secured very satisfactory results by 

 adopting the method recommended by Boiiley, of making one 

 comprehensive pimcture, which penetrates the canal without any 

 preUminary dissection of the incumbent parts, especially when a 

 catheter has been placed in the ui'ethra for the guidance of the 

 knife. The hemorrhage, which generally accompanies this mode 

 of operation is of no great importance, often subsiding of itself, 

 and seldom requmng external hemostatic appHcations. 



"NVe believe it to be the better coiirse, when the object in view 

 has been realized, to leave the wound to itself, without interfering 

 with the healing process by seeking to facilitate it by the appHca- 

 tion of sutures. It gradually granulates and closes without any 

 special care beyond the observance of cleanHness and the neces- 

 sary measures to prevent irritation of the skin from the contact 

 of the urine as it "leaks " through the wound. 



When the urethra has been opened, in whatever region of the 

 penis the offending foreign body may be lodged, it is readily 



