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lence done to the tissues by using the rongeur. He was passing water naturally, and his wounds were closed at the end of three weeks. He empties his bladder completely, has not to rise more than once at night, has become strong and vigorous and is able to attend to his business continuously. 4. There is also danger of tearing into the rec- tum — an accident which happened to me once in a cancerous prostate, and which is liable to happen to any one operating in a very dense or fibroid pros- tate. price of cipro Through cipro order the perineal wound small, or even large, pieces of the prostate cipro 500mg tissue may escape into the bladder in the process of enucleation. This to a cer- tain extent buying cipro online may be overcome with the larger nodules by catching each one with a well-curved tenaculum and drawing it down into the external wound buy cipro online before it is finally loosened from the capsule, but the very small ones are liable to get lost, and if allowed to remain in cipro online pharmacy the bladder would form nuclei for stones. On three cipro 250 mg occasions, I have had such pieces escape into the bladder, but I have alwavs been fortunate June 27,. 1903] MACGOIVAN: SURGERY OF THE PROSTATE. "73 cnonfrh to know it and to recover them without mak- ing;;- tlie suj)ra]iubic cut. Much time was lost, and the operation was gfrcatly prolonpod by reason of this accident. Case III. — June 29, 1899. J. B., aged seventy years. Merchant. Complains of burning in the bladder and increased urinary frequency. Urine very acid. No al1)umin, sugar, pus, or casts. Ex- ternal genital organs normal. Prostate slightly en- larged on right side. No residual urine. July 26th. After massage of prostate, urine passed was centrifuged and examined microscopi- cally. Uric acid sand, and calcium oxalate crystals, surrounded by clumps of pus. August 5th. Has taken cold and prostate is oede- malous and prominent. This attack was accom- panied by right-sided epididymoorchitis. Later, he became very comfortable and remained so until 1902, when, in May, after seeing a relative buy cheap cipro operated on for prostatic obstruction by me, he bethought him- self of his former attack and had a surgeon in a neighboring city examine him. He found he was carrying more than a pint of residual urine. The surgeon gave him a catheter to use, with which he very promptly infected himself. His prostate had grown to a very large size. After suffering a few weeks, he decided on operation. The enlarged cipro cheap glands were enucleated without difficulty, but one piece slipped away and got into the bladder. It required a long time to recover it. His external wound healed in ten days. The urine passed by the urethra naturally when he was lying in bed after twelve days, but he could not retain it when walk- ing about for nearly six weeks. This was due to the undue stretching of the bladder neck by the tumor having grown into it directly from both sides of the urethra, which interfered very greatly with the cost of cipro restoration of its tonicity. Within three months he retained his urine perfectly and his bladder empties itself to the last drop. He sleeps all night and only urinates four or five times during the twenty-four hours. This case illustrates very nicely commencing pros- tatic obstruction, its development and cure. 5. When the tissues of the bladder have been greatly bruised by sharp cipro online stones before the operation, cipro hc or where cipro 250mg the urine is hopelessly alkaline, with all that condition implies, all wounded surfaces within the bladder, and sometimes within the prostate, be- come covered with phosphatic incrustations. These are subsequently cast off, or may have to be loosened by curetting somewhere between the third week and the third month. In one case I had to reopen the suprapubic wound on this account, and took out a whole handful of sloughs covered with such de- posits. In another case, very recently, such sloughs came away through the perineal wound, which re- opened apparently cipro price from this cause, and subsequently closepurchase cipro online arose from an organized clot which had formed on one side of the bladder neck, and when the packing purchase cipro was re- moved and the perineal wound practically closed upon the restoration of the power of urination, this clot was swept into the urethra and, being firmly at- tached, remained there, causing tenesmus. The forcible contraction of the bladder neck upon the clot loosened it cipro 250 from its vessel and a hemorrhage then took place into buy cipro the bladder filling it to disten- tion in less than two hours. In the first case I was able to remove these clots and stop the haemorrhage by breaking them up with a lithotrite in a 15 per cent, solution of hydrogen dioxide in normal salt solution and subsequently pumping them cipro cost out with a Chismore evacuator. In the second case, the bleeding could not be controlled,

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