380 VETERINARY SURGICAL OPERATIONS 



The urethra is closed by interrupted catgut sutures ar- 

 ranged close together; then the space intervening between 

 the urethra and the deep perineal fascia is packed with iodo- 

 form gauze, the end of which is left to protrude from the in- 

 ferior commissure of the fascia and cutaneous 'incisions, each 

 of which (three in all) are sutured separately, the fascia in- 

 teguments with catgut and the skin with silk. 



AFTER-CARE. — The iodoform gauze is renewed daily 

 with as little molestation of the sutures as possible, and the 

 patient is kept standing to prevent injury of the wound by 

 the movements of lying and rising. At the end of eight days 

 the silk sutures are removed. 



ACCIDENTS AND SEQUELiE.— i. Vesical and Ure- 

 thral Haemorrhage. — In the extraction of a large and espe- 

 cially a rough stone, lacerations of the delicate and highly 

 vascular mucous membrane through which it is pulled with 

 more or less force, and copious bleeding seem inevitable. It 

 is, however, not serious and may be abandoned to spontane- 

 ous arrest. The greatest harm resulting therefrom is that 

 of. masking the work of suturing the urethral incision. The 

 blood gushes forth over the edges of the wound and thus 

 causes considerable annoyance until the urethra is entirely 

 closed. The coagulum in the bladder may sometimes be a 

 temporary obstruction, but as it 'is soon liquefied and voided, 

 little harm results. 



2. Cystitis. — The chronic cystitis caused by the sojourn 

 of the calculus is always excited into renewed activity by the 

 operation and may produce serious pelvic pains manifested 

 by harmful tenesmus. 



The condition is managed by irrigation of the bladder 

 once daily with hot antiseptic water, phenol one per cent, and 

 by the internal administration of urinary sedatives : bella- 

 donna, saw palmetto, copaiba, etc. 



3. Urinary Fistula.— This sequel, when the urethra is 

 not sutured, is one of choice, and is not regarded as a serious 

 matter, since the incision will eventually heal. On the other 

 hand, if the sutures fail to bring about an immediate closure 

 by healing, the discharge of urine through the incision may 

 be looked upon as a decided misfortune, in that instead of 

 the parts being healed entirely in ten days, several months 

 may elapse before the patient can be discharged as a cured 

 subject. Furthermore, urine often excites an annoying local 

 irritation by dissecting its way subcutaneously into the re- 

 gion of the sheath. 



The accident, is, however a rare one if asepsis prevailed 



