Anatomy, Surgical and topographical -- Atlases; Surgery -- Atlases; Surgery, Operative -- Atlases
FIG. 7, Plate 63.--Four calculi are contained in the bladder. This organ
is divided by two septa, 2, 4, into three compartments, each of which,
1, 3, 5, gives lodgment to a calculus; and another, 6, of these bodies
lies impacted in the prostatic canal, and becomes a complete bar to the
passage of a catheter. Supposing lithotomy to be performed in an
instance of this kind, it is probable that, after the extraction of the
calculi, 6, 5, the two upper ones, 3, 1, would, owing to their being
embedded in the walls of the bladder, escape the forceps.
[Illustration]
Plate 63,--Figure 7.
FIG. 8, Plate 63.-Two large polypi, and many smaller ones, appear
growing from the mucous membrane of the prostatic urethra and vesical
orifice, and obstructing these parts. In examining this case during life
by the sound, the two larger growths, 1, 2, were mistaken by the surgeon
for calculi. Such a mistake might well be excused if they happened to be
encrusted with lithic matter.
[Illustration]
Plate 63,--Figure 8.
FIG. 9, Plate 63.--The base of the bladder, 8, 8, appears dilated into a
large uniform sac, and separated from the upper part of the organ by a
circular horizontal fold, 2, 2. The ureters are also dilated. The left
ureter, 3, 4, opens into the sac below this fold, while the right ureter
opens above it into the bladder. In all cases of retention of urine from
permanent obstruction of the urethra, the ureters are generally found
more or less dilated. Two circumstances combine to this effect--while
the renal secretion continues to pass into the ureters from above, the
contents of the bladder under abdominal pressure are forced
regurgitating into them from below, through their orifices.
[Illustration]
Plate 63,--Figure 9.
FIG. 1, Plate 64.--The bladder, 6, appears symmetrically sacculated. One
sac, 1, is formed at its summit, others, 3, 2, project laterally, and
two more, 5, 4, from its base. The ureters, 7, 7, are dilated, and enter
the bladder between the lateral and inferior sacs.
[Illustration]
Plate 64,--Figure 1.
Fig. 2, Plate 64.--The prostate is greatly enlarged, and forms a narrow
ring around the vesical orifice. Through this an instrument, 12, enters
the bladder. The walls of the bladder are thickened and sacculated. On
its left side appear numerous sacs, 2, 3, 4, 5, 6, 7, 8, and on the
inner surface of its right side appear the orifices of as many more. On
its summit another sac is formed. The ureters, 9, are dilated.
[Illustration]
Plate 64,--Figure 2.
FIG. 3, Plate 64.--The prostate is enlarged, its canal is narrowed, and
the bladder is thickened and contracted. A calculus, 1, 2, appears
occupying nearly the whole vesical interior. The incision in the neck of
the bladder in lithotomy must necessarily be extensive, to admit of the
extraction of a stone of this size.
[Illustration]
Plate 64,--Figure 3.
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