Case 50: Deep Stricture of Large Caliber with Irritable Bladder.
—A medical man, 36 years of age, consulted me regarding an intractable gleet, with chronic cystitis and a small perineal fistula. I found the bladder in fairly good condition, the so-called chronic cystitis being a chronic follicular prostatitis (so-called posterior urethritis) from old gonorrheal infection. The urethra would admit a 28 French sound, but there was marked deep spasm. With a 15 bulb (bulb exploratrice of Guyon) a distinct large calibered linear stricture was found at the bulbo-membranous junction. The condition of this case and the indications seemed perfectly plain. Infection from the imperfectly drained canal behind the stricture, explained the chronicity of the prostatic trouble, and the occurrence of a small peri-urethral abscess which had undoubtedly preceded the fistula. The reflex irritation produced by the stricture was sufficient to account for the spasmodic contraction of the true sphincter vesicæ
LYDSTON GF. INTERESTING CASES OF PERINEAL SECTION, WITH REMARKS. JAMA. 1896;XXVI(12):578–581. doi:10.1001/jama.1896.02430640030001j
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