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February 8, 1890

EPICYSTIC SURGICAL FISTULA, FOR THE RELIEF OF VESICAL CATARRH.Read by Title in the Section of Surgery and Anatomy, at the Fortieth Annual Meeting of the American Medical Association, June, 1889.

Author Affiliations


JAMA. 1890;XIV(6):191-195. doi:10.1001/jama.1890.02410060011001b

The treatment of vesical catarrh by suprapubic drainage, irrespective of the causes producing the disease, is not only the most rational, theoretically, but the most available and successful. Such has been the palliative, restorative and curative effect of suprapubic drainage in cases of suppurative cystitis that I have treated by this method, that I have repeatedly resorted to it, with the happiest results.

A close observation of my cases, though at first giving me much anxiety and apprehension, taught me the valued lesson of suprapubic drainage in cystitis. The epicystic fistula gives a desirable continuous drainage, I have not been able to get by any other method. The fistula possesses the ability, through the recti muscles, and a possible pseudo-sphincter, to control the urine at all times. The pseudo-sphincter muscle is formed, no doubt, by the fibres of the detrusor urinæ.

I have tried drainage of the bladder by perineal