92 



URETHROTOMY. LITtlOTOMY. 



of the neck of the bladder with the lithotome can be under- 

 taken as a last resort. Introduce the instrument closed into 

 the bladder, it is then opened and the neck of the bladder 

 divided upward and laterally as the instrument is withdrawn. 

 In order to prevent injury to the rectum it should be emptied 

 before the operation is undertaken. After the removal of 

 the stone, push the catheter again over the ischial arch and 

 unite the lips of the wound in the urethral mucous mem- 



FlG. 9. Urethrotomy (life size). ;^, skin ; a, retractor penis muscle ; 

 b-, bulbo-cavernous '.muscle ; c, spongy urethra ; u, urethra ; k, 

 catheter. 



brane by means of intestinal sutures. Flush the bladder or 

 urethra by means of a warm 3 per cent, boric acid solution 

 injected through the catheter and then withdraw the latter. 

 Finally, suture the .skin wound and insert a drainage tube 

 or iodoform gauze in the lower angle of the wound. The 

 whole wound may be left entirely open and be dres.sed daily 

 with antiseptics. For student practice, on an anae.sthetized 

 horse, introduce a stone into the bladder through the ure- 

 thral wound and practice grasping and removing it with the 

 lithotomy forceps. 



