Second stage of lithotomy. (Erichsen.)
The same management is required after lateral as after median operation. Except only when a long and seriously inflamed bladder requires almost permanent drainage the perineal tube should be removed within forty-eight hours, and the external opening allowed to close as rapidly as possible.
TUMORS OF THE BLADDER.
The most common benign tumor of the bladder is papilloma, which here assumes almost invariably the villous form and grows even luxuriantly. It may be solitary or multiple. In the beginning it is usually more or less pedunculated, but may grow in great numbers, as in the mouth. A class of denser tumors are the fibromas, which are covered by a more or less thickened mucous membrane. Myxomas grow mainly in children. Adenomas have been described, but are rare. Dermoid cysts in or about the walls of the bladder have also been described. The malignant tumors of the bladder are mainly of the epithelial type, usually adenocarcinoma, of a somewhat peculiar type, due to malignant degeneration of an original papilloma, an unfortunately common event ([Fig. 656]).
Fig. 656
Fig. 657
Villous tumor (papilloma) of bladder. (Musée Dupuytren.)
Tumor of bladder as seen with cystoscope. (Nitze.)