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THE PREVENTION AND TREATMENT OF URETHRAL STRICTURE OF INFLAMMATORY ORIGIN
Author(s) -
AinsworthDavis J. C.
Publication year - 1933
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1933.tb11173.x
Subject(s) - medicine , gonorrhea , urethral stricture , surgery , urethra , attendance , general surgery , intensive care medicine , family medicine , human immunodeficiency virus (hiv) , economics , economic growth
Summary (1) Stricture is due to imperfectly treated gonorrhea, and it may take years to develop. Such treatment was common during the Great War because of the urgency of getting officers and men back to the firing line, and so the ill results of this are just beginning to be seen and will continue for the next twenty or more years. (2) Stricture should always be thought of and prevented in every case of gonorrhea by adequate instrumental treatment. (3) Stricture and its complications are of such a serious nature that every effort should be made to ensure early diagnosis and treatment. Unfortunately, symptoms are rarely experienced before the calibre of the urethra has been reduced to about one‐third of its normal extent, Le., 15 Charrière. (4) Stricture is curable providing treatment is carried out in the right way, which consists in making it retrace its own footsteps by regular instrumentation, which gradually brings about rupture of the inner layers of fibrous tissue, which are then absorbed during the intervals of treatment. (5) Efficient local anaesthesia renders this treatment painless, a great factor in ensuring regular attendance. (6) Late diagnosis and the presence of complications call for the use of a variety of peri‐urethral instruments, which are described. (7) Neglected cases and the occurrence of certain severe complications may necessitate operations, sometimes immediate, as a life‐saving measure. The best procedure is suprapubic cystotomy, any direct operative attack on the stricture being avoided at the time, and an attempt made by instrumentation at a later date. (8) The treatment of certain pre‐ and post‐instrumental complications of stricture is summarised.