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On the other hand, dilatation with incision, or incision alone as practised by the English surgeons, has proved dangerous cases had subsequent incontinence.

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There no danger this if Simon's method be Lithotrity or litholapaxy indicated in the female when the stone over inch in diameter, or when composed salts deposited upon some foreign body.

Fergusson gives a list cases in which has done lithotrity in girls with most brilliant results, nearly always removing all the fragments at the first sitting. And Walsham has collected altogether eight cases lithotrity in girls under fifteen years age, with and without previous urethral dilatation, in all which there was complete cure without incontinence. In three these latter cases repeated operations were necessary account the size the fragments. The patients are narcotized and put in the lithotomy position. Then the bladder filled with three five ounces lukewarm water, the instrument warmed, greased with carbolized oil. The stone then guided from the vagina in adults, from the rectum in children, into the jaws the instrument, and broken.

After this more water injected into the bladder, the smallest Simon's specula introduced, and as many calculi as possible removed. Then search should made for larger fragments which may have remained behind per vaginam, and the urethra best essay dilated still further, or lithotrity repeated. The after-treatment that vesical catarrh.

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The vesico-vaginal incision employed when the stone over inch in size, and too hard crushed. Fabricius Hildanus was the first It was long the practise when the calculus was lodged in a cystocele, incise the sac for the removal paraphrasing worksheets 5th grade the stone this has been done Rosset, and Ruysch. Or a hollow sound was passed into the bladder, the point pressed against the vesico-vaginal septum, and the cut made down upon the groove.

The description of Simon's T-incision, which only needed with very large stones, given page. Walsham states that means the vesico-vaginal incision out children were completely cured write my essay for cheap remained incontinent from laceration the soft parts and the urethra in extraction. i cant write my essay The vesicovaginal incision in the female far the best operation for the extraction calculi. According Aveling there was only death operations this kind. But in children the calculus may large that cannot pass through the lesser pelvis, or can only dragged through with much laceration the soft parts and this may even the case in adults, as in Josephrs cases extra-uterine pregnancy with The vestibular incision. We mentioned in the introduction the Celsian operation for stone in women, and saw how indefinite his description was since cannot understand what means sed virgini sub ima sinisteriora. The statement mulieri vero inter urinas iter et pubis incidendum est clearer, and evidently means something like the operation which Lisfranc proposed, but did not upon the living subject. He proposed that an assistant should press down the point a male catheter, which had been introduced into the bladder with its convexity upwards, while another assistant forcibly separates the labia minora. Then the operator cuts with a straight bistoury, beginning above the urethra, and going from right left, dividing mucous membrane, connective tissue, and the constrictor cunni. Under the symphysis, without injuring the pudendal artery, whose pulsations can plainly felt, enters the anterior vesical wall, and cuts longitudinally or transversely. But the space obtained work in smaller, and the hemorrhage i need help with a research paper more serious than in other methods.

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