4. A yard and a half of fine india-rubber tubing.
Fig. 90.—A silver catheter tied in the urethra.
A narrow roller is tied round the hips; from this, on each side, a tape is passed round the thigh at the groin, and fastened before and behind to the roller round the hips (see fig. 90); a narrow tape run through the rings of the catheter connects them with the loops in the groins. The tapes are tied short enough to prevent the catheter slipping out; a yard or two of narrow india-rubber tubing, fixed on to the end of the catheter, conveys the urine to a pan under the bed, and keeps the bed dry, or a spigot of wood fitted to the catheter may be inserted, for the patient to draw out when he desires to void his urine.
To Tie in a Flexible Catheter. (Fig. 91.)
Apparatus.—1. A piece of soft twine, or Berlin wool, about 15 inches long.
Fig. 91.—A flexible catheter tied in the urethra; the string fastened behind the corona glandis, and concealed by the foreskin.
A catheter is first passed into the bladder, and the urine runs off. The catheter is then gently withdrawn, till the stream ceases, that the end of the instrument may remain just without the neck of the bladder. The string should be tied round the catheter ½ an inch from the meatus, its ends gathered together and tied in a knot about 1 inch farther on. The foreskin is then drawn back, the ends passed beneath the glans and tied round the penis behind the corona; the superfluous string is snipped off, and the foreskin brought forward. The catheter is cut off obliquely ½ an inch beyond the string and then stopped with a spigot, direction being given to the patient to withdraw the spigot, and push the catheter a little further in when he wants to make water.
To Tie a Patient in Position for Lithotomy.