■ .. >F VI cost of renova : (ONTANUM.
there are some diagnoses and treatments, generally
pertaining to special organs, information concern-
ing which ''goes into one ear and comes out of the
other," leaving behind only the vaguest ideas upon
the subject. The need of special instruments or
special training of the eye or hand, or of both.
deters the average physician from any adequate
preparation for such work, even when his attention
has been successfully fixed upon its importance buy renova online and,
if he does attempt purchase renova online it, it is in a half hearted, un-
it ientific manner, the results of which are nil.
For example, in a case sent me for consultation,
the leading physician in a large, neighboring town
fondly imagined he was carrying out my suggestion
to massage the seminal renova cream vesicles, by manipulating
the tip of a order renova sound in the prostatic urethra. I do
not believe it an exaggeration to state that not one
physician out of fifty, even in the cities, really
knows this part of the rectum with his fingers and
brain and can expel seminal excretion unless the
vesicles are greatly renova canada distended. Even the best sur-
geons, whose discount renova vaginal and abdominal touch is mar-
velously acute, fail in this particular. Every spe-
cialty has just such untrodden fields.
The subject of my paper, however, deals with a
certain field of one specialty which is overlooked
by most of the specialists themselves. Since the
practical application of the urethroscope about
thirty-five years ago. fairly numerous articles, forty
at least, have appeared in renova prices English and German, de-
scribing the method of examination of the veru-
montanum, its anatomy, its diseases, and their treat-
ment, and citing results which are simply startling
in many cases. Nevertheless, few of the genito-
urinary specialists are working along these lines.
Indeed, this treatment has been described as bar-
barous by one of the best known members of thi-.
association. No textbook on genitourinary diseases
devotes much more than a mention to the subject.
The verumontanum is a protuberance, one eighth
of an inch or more in height, arising from the floor
of the prostatic urethra, and resembling a nipple
in form as seen in the urethroscope. It is com-
posed of muscular and erectile price of renova tissue, the latter, it
is asserted, serving to prevent the back flow of the
semen during the orgasm. On its anterior surface
is a blind pouch, the sinus pocularis, at or within
the margin of which the ejaculatory ducts emerge.
Its color is a trifle paler than the surrounding mu-
cous membrane. In the furrows on both sides air
found the openings of the prostatic ducts.
The appearance of the verumontanum when dis
eased varies greatly, the. most frequent changi be
in- that it is red and hypersemic, bleeding at the
slightest touch. If it is not already discolored b\
lil» 'I when brought into view by the urethroscope,
the first touch of the cotton swab causes hremor-
rhage and frequently, as the urethroscope is with
drawn, the part which falls into the opening bleeds
profusely on account of the sudden relief from
pressure. It often appears considerably enlarged
and in other cases uneven also with irregular ex
cresences resembling the surface of a blackberry.
Its color becomes more fiery, according buy renova t' the
■grade of inflammation. Finger describes a later
stage, a change into connective tissue thus con-
tracting the ejaculatory ducts, hut this I have nol
observed. Swinburne and Wossidlo have each de
scribed the finding of two polypi projecting from
To George K. Swinburne, of New York, belongs
the honor of having been the first to devise an
urethroscope which can be easily used without ex-
cessive pain to the patient, to study and treat these
pathological conditions. The introduction and re-
tention of the straight urethroscope are exceedingly
painful, even in a normal urethra. To overcome
this. Doctor Swinburne devised in 1900 a tube with
an angle like a stone searcher, which is a great deal
easier and less painful to introduce and retain. The
window is on the convex surface of the angle and
is closed with an obturator.
One great advantage of this instrument is that it
is provided with an auxiliary tube which contains
the light carrier. In the ordinary instrument the
light renova online carrier must be removed before swabbing the
urethra, and in doing this one is apt to withdraw
the tube or to push it in farther, thus losing the area
which he was observing from view. The manipula-
tion of the instrument is very delicate at the best,
and every extra disadvantage should be avoided.
It may he asked why the swab may not be used in
the ordinary -inule urethroscope tube, without re-
moving the light carrier. If this is done the cotton
will catch on the pointed end renova cost of the incandescent bulb
when removing the swab, and buy renova cream is very likely to break
it. The where can i buy renova danger of introducing fragments of renova uk broken
glass into the posterior renova coupon urethra could hardly, of
course, be overestimated. Another advantage of
the auxiliary tube is cheap renova the avoidance of the confusing
reflections of the light.
The instrument is renova purchase introduced with the patient ly-
ing on his back, the hips being slightly elevated. The
fingers of the other hand press downward on either renova price
side of the base of the penis to relax the sphincter
muscle. A jerk will he felt as the angle passes the
sphincter, and, if the instrument is advanced about
one half inch farther, the verumontanum will be
found projecting into the window upon withdraw-
ing the obturator.
The aetiology of disease of the verumontanum i-
generally gonorrhoea!, although excessive masturb..
tion or coitus, prolonged sexual stimulation without
gratification, as in hugging, withdrawal, or coitus
interruptus or pri nay cause it without
The symptoms which may be produced by disease
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