Aggressive stricture treatment
These photographs were taken by Mr Geoff Willis, in the 1970s, of instruments in the Museum of the Manchester Medical School.
Described by Barnard Wright Holt, Senior Surgeon and Lecturer on Clinical Surgery at the Westminster Hospital, and Medical Officer of Health for Westminster, 14 Savile Row, Burlington Gardens. The surgical technique is described in his 1863 book "On the Immediate Treatment of Strictures of the Urethra by Employment of the Stricture Dilator".
Holt denounced the too-timid treatment of stricture and the tedious, slow, gentle dilatation that could take many months. He, therefore, adopted a more energetic mode of treatment with his new stricture dilator.
The instrument consisted of two grooved blades, fixed in a divided handle, through which graduated rods could be passed to dilate the stricture. In the third edition of his book, Holt suggests that, rather than gradually dilating, the largest rod should be passed straight away to open the stricture quickly.
Holt decided against immediate catheterisation as it caused irritation. Instead, he suggested intermittent catheterisation, initially on alternate days and then at longer intervals - not too different from what we would suggest now.
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