UEETHROTOMT. 



563 



Fl8. 470.— Secure for Isoliial Urethrotomy. 



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

 grooved director, a blunt bistoury beiag 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 Bouley, of making one 

 comprehensive puncture, which penetrates the canal without any 

 preliminary dissection of the incumbent parts, especially when a 

 catheter has been placed in the urethra 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 requiring external hemostatic applications. 



We believe it to be the better course, 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 applica- 

 tion of sutures. It gradually granulates and closes without any 

 special care beyond the observance of cleanliness 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 



