Scientific American Supplement, No. 648, June 2, 1888.Various
Science
Scientific American Supplement, No. 648, June 2, 1888.
Various
Science -- Periodicals
The above shortly described fifteen[9] cases of bladder tumors have been
diagnosed by me cystoscopically during the last sixteen months. This is a
proof, on the one hand, of the value of the cystoscopic examination; on
the other hand, of the fact that the new formations in question are not of
so rare occurrence as has been hitherto thought. I would like to emphasize
that the important results were often obtained under the most difficult
circumstances. In several cases the external orifice of the urethra was
found abnormally small; in others (Cases 8 and 11) the examination was
made during the occurrence of a continuous hemorrhage from the tumor; in
one case (Case 1) I introduced the instrument through the center of the
tumor, which bled on the slightest pressure. In spite of this the
appearances were seen satisfactorily. In the first case a post mortem
examination was made; in eight other cases (Cases 2, 3, 9, 10, 11, 13, 14,
and 15) the tumor was extirpated, seven times by the high section--in one
case, that of a woman, through the dilated urethra. In these nine cases
the endoscopic appearances were in every important respect confirmed in
the most perfect manner. In every case my opinion regarding the size,
position, and form was found to be correct. It is only in those cases
where the edges of the tumor overlap the short pedicle that the latter
cannot be observed. Besides, the relative good results of the operations
undertaken on account of the cystoscopic appearance may be emphasized. Of
the eight patients from whom the tumors had been extirpated, none died
from the result of the operation. Case 9 proved fatal on account of the
progressive extension of the growth. In the eleventh case there was a
recurrence, but the patient is still alive. Five patients (Cases 2, 3, 10,
13, 14) must be considered entirely cured. Case 15 is still under
treatment, and, as the conditions of the patient are at present (ninth day
after operation) in every way satisfactory, a complete recovery is
anticipated.
[9] The first eight cases are more fully described in the Arch. fur
Chirurgie, vol. xxxvi., Part 3 (Dr. Nitze, Beitrage zur Endoscopie der
mannlichen Harnblase). The full account of the last seven cases will be
published soon.
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