A Mirror of

Hospital Practice

LITHOLAPAXY IN A CASE OF

CYSTOCELE

By E. T. N. TAYLOR MAJOR, I.M.S.

Civil

Surgeon, Manipur, Imphal,

Assavi

A Manipuri female, aged 72 years, came in with a cystocele of the size of a hen's egg which projected through the vulval orifice, and inside it the major portion of a stone could be distinctly palpated. She had symptoms of the stone early in 1934. Micturition became more frequent and painful owing to the amount of straining required to pass urine, and about June

1936 she first noticed the protruding cystocele She demonstrated how she had to reduce the cystocele manually before passing urine. Owing to the extreme emaciation and feebleness, it wag decided to do the operation without a) general ansesthetic. On 15th June, 1937, while the patient was under the influence of morphia i gr., the assistant reduced the cystocele with two fingers in the vagina while the phosphatic stone was carefully and rapidly crushpd by a large lithotrite with scarcely any discomfort to the patient owing to the ease with which the pieces of stone could be manipulated into the jaws of the lithotrite. A large urethra made the evacuation of the fragments an easy affair. The weight of the

740 dried

THE INDIAN MEDICAL GAZETTE

fragments was 600 grains. Convalescence was rapid and the patient left the hospital on the 20th. On 9th September, at my request, she walked a mile to the hospital to report herself. The general condition was greatly improved. She denies emphatically any urinary discomfort, though the cystocele is still present in a lesser degree.

[Dec.,

1937

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