A case of extroversion of the bladder treated by preliminary narrowing of the gap existing in the pubic symphysis by means of division of the sacro-iliac synchondroses / by G.H. Makins.

  • Makins, George Henry, 1853-1933.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A case of extroversion of the bladder treated by preliminary narrowing of the gap existing in the pubic symphysis by means of division of the sacro-iliac synchondroses / by G.H. Makins. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    healed, except a small granulation on the left side. The exposed surface of bladder now measures only one and a half inches in each direction, and the anterior superior spines are one inch nearer than before operation. The decrease in the size of the exposed surface of the bladder Fig. 2.—b Shows line of sutures. is due not to mere contraction from relief of tension but to the formation of a deep groove on either side sufficient to contain some small quantity of urine as the patient lies on his back. 9.15 a.m., anaesthetised with chloroform. An incision, commencing one inch above the top limit of the bladder in the mid-line, was carried downwards on each side of the bladder to the lateral margins of the urethra ; the skin was raised for about an inch and then drawn over the exposed bladder ; the lower half was easily closed •without the least tension, but the old cicatrix on the left side pre- vented the upper half meeting without tension, so that the skin had to be freed in an upward direction on that side for three quarters of an inch and then drawn down to fill the gap, the cicatrix being quite immovable. This portion of the operation is explained by diagrams 1 and 2. The lower margin of the abdominal skin was sutured to the margins of the penis, but no attempt was made to close the urethra.