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 defecation. 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 
Fig. 170.—Median section of tlie bladder, urethra, vagina, and vulva of a cow. a , Yao-ina • 
b, vulva ; d, bladder ; e, urethra ; /, valve of the urethra ; g, clitoris. 
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 conse¬ 
quence 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 : 
the urethra must not be injured internally, nor must infectious or 
decomposing material be introduced into it. Failure to observe the 
latter precaution may result in decomposition of the urine, inflamma¬ 
tion of the bladder (cystitis), or even often fatal pyelonephritis, on 
account of the inflammatory processes spreading as far as the pelvis of 
the kidney. 
In Germany elastic rubber tubes are generally employed, whose outer 
opening is somewhat dilated, whilst the opposite end possesses one or 
two lateral openings (eyes), by which the urine may enter the catheter. 
A suitable stilette serves to assist the introduction and cleansing of the 
instrument. 
