WOUNDS OF THE URETHRA.
Actual wounds occur in surgical operations, or accidentally as by shafts, poles, forks, hooks, bites, etc., or from calculus or a catheter forced into a false route. An arrested or slowly moving calculus has been known to induce several perforating ulcers causing infiltration of urine and infecting germs into the connective tissue. This determines rapidly increasing œdematous fluctuating tumors. Gangrene and septic intoxication are common results, especially in cattle.
Longitudinal wounds keep more open and heal more readily than transverse wounds, probably because the circular muscular fibres in contracting, pull the edges apart and counteract stricture, the breach being filled up by granulations. The perineal wound in lithotomy will heal thus in 20 days, while that made in amputation of the penis is exceedingly liable to circular contraction and stricture or occlusion.
Contusions of the perineum, may cause lacerations of the urethra and hæmorrhages, with bloody discharge or sanguineous swelling.
Treatment. Will vary. Calculi must be diagnosed and removed. Breach of the walls of the urethra may necessitate frequent catheterization or, better, the wearing of a catheter. Escape of urine into the connective tissue should be met by a counter opening in the skin to drain the part and allow free antisepsis. Similar resorts are required for urinary infiltration, accompanied by antiseptic injection subcutem. Abscesses must be located, punctured with trochar and cannula, evacuated and injected antiseptically.