It is generally recognized that urinary obstruction at the vesical orifice may be caused by various conditions other than prostatic hypertrophy. Such conditions may be divided into three groups, namely, contracture of the bladder neck, glandular and inflammatory tissue formation, and congenital obstructions.
Methods have been devised for removing the obstruction caused by contraction at the vesical orifice, such as the Chetwood and modified Bottini operations, and the Goldschmit technic. However, n o method short of resection had been definitely suggested for the removal of obstructing glandular and inflammatory tissue until that described by Young in 1912. He demonstrated that such obstructions could be removed by endoscopic methods under local anesthesia, and without incapacitating the patient for more than a few days. The instrument he used was called a median bar excisor, and while the instrument was indeed a very serviceable one, the operator was handicapped by the fact that
BRAASCH WF. MEDIAN BAR EXCISOR. JAMA. 1918;70(11):758–759. doi:https://doi.org/10.1001/jama.1918.02600110016005
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