The  dangers  of  the  introduction  of  an  instrument  into  the  urethra  arc  shock,
when  the  urethra  is  hj-persensitive,  a  comlitinn  which  may  be  remedied  by
distending  the  uretha  with  a  one  or  two  per  cent,  solution  of  cocain;  hem-
orrhage, which  may  be  avoided  by  gentleness;  false  passages  (p.  637) ;  and
septic  processes,  e.g.,  prostatitis,  epididymitis,  cystitis,  and  urinary  fever.
Tlie  treatment  of  stricttire  is  (i)  dilatation,  (3)  urethrotomy,  or  (3)  ure-
Ihrcctomy.  i.  Dilatation  may  be  gradual,  rapid,  or  continuous.  Gradual
dilalalion  is  the  best  treatment  for  all  non-resilient  strictures  through  which
an  instrument  can  be  passed.  The  largest  sound  which  the  stricture  will  admit
is  introduced  and  allowed  to  remain  a  few  minutes;  this  is  repeated  twice  a
week  with  larger  instruments,  until  the  stricture  is  as  large  as  the  meatus
(from  27  to  32  F.).  The  patient  should  take  a  urinary  antiseptic  during  the
treatment,  which  should  always  be  suspended  if  there  is  much  irritation.
Rapid  diiaUUion  is  less  desirable,  even  though  it  saves  time;  it  consists  in  the
introduction  of  larger  bougies,  one  after  the  other,  at  the  same  sitting,  until
the  full  size  is  reached.  Continuous  dUatalion  is  useful  in  very  small  stric-
tures. The  patient  is  confined  to  bed,  and  a  fine  bougie  introduced  and  kept
in  place  for  a  day  or  two,  when  it  will  be  found  that  a  larger  instrument  can
be  passed.  This  is  continued  until  a  large  instrument  can  be  passed,  when
gradual  or  rapid  dilatation  may  be  substituted.  Filiform  bougies  (less  than
I  mm.  in  diameter)  are  made  of  whalebone  and  used  for  the  finest  strictures.
A  filiform  bougie  is  apt  to  enter  one  of  the  crypts  in  the  urethra,  in  which  case
il  should  be  partly  withdrawn,  then  pushed  onward  with  a  rotary  movement.
