US1644919A - Instrument for treating urethritis - Google Patents

Description

o. HAYES INSTRUMENT FOR TREATING URETHRITIS Oct. 11,1921 1,644,919

Filed March 8. l9 26 /Z0 g; j/ 76; 2 M5 L9 /7' INVENTOR. Oscafrhfirrs Patented Oct. 11, 1927 UNITED STATES osoAR HaYEs, or Axaomonio.

.msmmmmimn TREATING URETHRiTISr Application fil d March 8, i1926 .":Seria1 No.93,060.

I This invention relates to instruments for treat ng urethr tis and condltions resulting therefrom. o ,i

i. 4 ln chronicui-ethi'itis the pathologic lactors that are most. important in explaining the persistency offthe disease are str cture,

' I congested and granularpatches,enlargement and inflammation of 'the lacuna magna', 1a-

, -cuna of urethifa and the urethral finucuous o i,

follicles.

The chiefsourceof the discharge the fmucuons folliclesofthe urethra "involved in the chronic nflammation and granular large this meatus, by'iperiormlng a slight h patchesalong the flfifobi of the, urethra, and

frequently situated immediately behind'the 'strictured areas; i i

' Stricture ofH diminutionlof its caliben temporary or permanent. The type I of stricture inost fre- M y and inflammation resulting from a bacter'ial' infection.

quently nietQWith inthe treatment of'c'hronic urethritis has been caused by the congestion Some ofithe procedures employed "surgeons in treatingfthe' aboveconditionsare:

- the use of 5 metal sounds, silk orT rubber .bougies and mechanical dilators. These inf struments arejcylindric al in shapeand have i a smooth surface and their action is'to spread and Idilate the tissues, 'The result. being that the strictures by gradually in-' i ,l creasingth'ediameterofthesounds, bougies" or dilators from time totimeare stretched and graduallyienlarged to the normal ,c ali-l ber of theurethra, thus thelstric'tured area ,lS eventually corrected. However, this procedure is'frequently veryfpainfuland at n times the tissues are'torn' and lacerated and torn areas have healed.

bougies ordilatorsare used for the purpose of stretching or emptyin'gthe lacuna and urethral follicles; particularly the latter the" action is incomplete, as it is obvious that when the canal is stretehed'to capacity the mouths or openings to the follicles are closed have taken place. In introducing:

before the complete emptying of the pockets 7,

. of pushing theinfection further down to he urethra is'an 'abnormal l v 4 'nstruments or the cylin- 'drical'type into the urethra there'is danger 7 Mechanical dilators act very much the same as'the sounds or bougies only'thatthey are faster in their action, more painful to "the patient, and are liableto domore damcent of cases is larger than the opening of I I themeatus, and it becomes necessary to enoperation; to permit I the introduction of I sounds or bougiesof suficientdiameter. V The present invention contemplates the application of a principle to urethral instrumentsvvhich is unique and has not heretofore been used Ttis proposed to construct sounds and bougies and catheters along the same generallinesthat are now in "use, only that the surface, instead of being cylindrical, has a spiral raised area beginning Irom its tipand extendinga part Way "or the entire length of the instrument. In, other Words, the body of the instrument will" consist of a shaft, the spirals covering the body of the instrument. These spirals are 'conveXed,' smoothed and rounded to permit easy introduction Without doing any damage to'the'tissuel. I The spiral metal sound is more easily'in-o troduced into a strictured" urethra than than eitherjstraight or curved metal sounds,

.silkor rubber bou'gies of the smooth cylin- V.

r type. The actionvof theinstrument' My with only a slight rotary motion produced treatment necessarily has to'ceaseunt l the by the operator-causes itto worm itsWay vinto thecanal'towardsthe bladder." The When the cyli drical: type of sounds "body or shaft of the spiral sound can befof a small diameter and the. spirals can be of different elevations v on different instruments thus permitting a sound of a larger effective diameter'to be introduced through a stricwithout tearing the tissues than with the old type of instruments. When'thespiral sound is introduced into the urethral canal the operator may grasp I ture with less tension; painor damage, and

the instrument, holding it firmly, preventing' the instrumentrotating When it is Withdrawn sothat by thespirals passing over the stricture ar'ea' every'portion of the stricv ture Will be massaged by the progressive tion is produced which causes regeneration,

and a healthy normal condition of the tissues is thereby obtained. I'Vhenit is desired to empty the urethral follicles, the spiral action on introduction, as well. as withdrawal, has a tendency to completely milk out and empty the follicles because the pressure begins at the bottom of follicles leaving the mouth unobstructed,

action withdraws all material found in the thus permitting the follicular contents to come to the surface of'the follicles. 20:

A spiral bougie of flexible material will have the same action as the straight or rigid type, and will also pass through the curved portion of the urethra, enabling the operator to obtain the same results in the prostatic urethra, as well as the pendulous portion of it.

V A catheter constructed along the lines of thoseformerly in use, only with the spiral elevations, secures the same general benefit off the spiral bougies'for it will find its way through the urethral canal much easier than the old type. It is possible to introduce a spiral catheter through the urethra into the bladder where the cylindrical type will fail to enter, particularly in those patients with an enlargement of'the prostate gland.

The danger ofpushing infected substances, fluid or pus into the urethra by the spiral sounds, is much less than With the other type of urethral instruments... The spiral urethra out towards the meatus or outside, where the other types of instruments will a push these materials or infections inward toward the bladder.

Since the shaft or barrel of the spiral sound, bougie or catheter is smaller than the outside diameter of the spiral surface, it is possible to introduce much larger spiral instruments through a contracted meatus than with the old cyl1ndr1cal type. For example, a meatus which Wlll permit the 1n- .troduction of an instrument no larger than 7 'formsthereof as shown and described below.

Of the accompanying drawings, Figure 1 illustrates a diseased urethral canal;

Figure 2 illustrates. a metal sound, embodying and adapted to' carry out the invention, in said canal; and

Figure 3 illustrates a flexible catheter embodying the invention.

Referringtothe'drawings, 10 represents a diseased urethral canal having, for example, congested and granular -patches as indicated at 11 and a stricture as indicated A metallic sound embodying the invention is shown generally at 13 (Figure 2) and comprises a cylindrical shank 14 having a raised spiral rib l5 thereon extending from a comparatively blunt end 14 to a point spaced from a handle 16' sufficiently to permit working of the spiraled' portion of the instrument held against rotation back and forth entirely within the canal so 'as not to cause needless pain. The surface of rib 15 is convex or rounded and smooth so as to massage the wall of the canal without lacerating the tissues. The handle 16 is preferably of suitable shape in section (hexagon shape, for example) so as to facilitate rotation of the instrument by the hand and also to facilitate holding it against rotation. The instrument is of such length that it may be worked well into the urethral canal toward the bladder.

In Figure 3 a catheter 17 is shown. This comprises a flexible hollow tube 18 of material such as rubber having a spiral rib 19 thereon similar to rib 15. The entering end of the catheter has the usual aperture 20 therein. The body portion of the instrument, however, is smooth and imperforate so as not to injure the tissues.

It is, of course, to be understood that the sounds, bougies or catheters may be of rigid or flexible material and either solid or hollow. In every case, however, they are formed with spiral ribs, suchas 15 or 19, to secure the benefits of the invention.

In practice, the canal 10- to' be treated is preferably first filled with a suitable lubricating, non-greasy, mildly antiseptic jelly, such as boric acid jelly. The instrument, preferably similarly lubricated, is then introduced into the canal by forcing it inwardly while rotating. Due to the formation of the instrument this is easily accomplished with a minimum of pain since the perimeter of the instrument at any point is less than the circumference of an equivalent cylindrical instrument.

The spiraled portion of the instrument is entirely introduced (Figure 2) in the above manner. The wall of the canal is then massaged by the instrument by holding it against rotation and moving it back and forth- The massaging and dilating action of the spiral rib on the wall of the canal at any point, for example, at the stricture 12, is progressively and rotatively about the normal caliber of the canal. This massaging action on the follicles thoroughly milks them of the pus. It will be seen that under this action of the spiral rib when entering,

the tendency to carry the pus back into the bladder is obviated, and upon Withdrawal of i the instrument, the pus that has been massaged from the wall of the canal will be effectively Withdrawn. i Modifications ofthe invention may be resorted to without departing from the spirit thereof or the scope of'the appended claims. a

What is claimed is: I v

1. An instrument comprising flexible shank of uniform diameter andimperforate throughout the body portion thereof formed with a closed enteringend and having an aperture therein adjacent said end, said shank having a fixed, spiral, roundt ed ribof uniform height on the body portion thereof.

2. An instrument for treating urethritis comprising a flexible shank of uniform diameter and smooth throughout the body portion thereof and formed throughout said body portion with a fixed continuous spiral rib of uniform height, said rib being smoothand rounded. 1 3. An instrument for treating urethritis,

said instrument comprising a shank of uniform diameter slightly tapered or rounded at its entering end and smooth throughout its body portion and having, a handle on one end and formed with a fixed continuous rounded spiral rib of uniform height extending from a point spaced from said u o r handle to the entering end of said shank.

a hollow 4. A sound, bougie or the like, comprising a V cylindrical shank of unlform diameter throughout the length of its dilating portion and having a smooth surface on said dilating portion on which is raised a fixed continuous splral rib.

OSCAR HAYES.

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