If in the free protractile portion of the penis
Treatment of urethral calculus may be begun by an attempt to extract the calculi by manipulation of the papilla on the end of the penis. This failing, the calculus may be seized with a pair of fine-pointed forceps and withdrawn from the urethra; or, if necessary, a probe-pointed knife may be inserted and the urethra slightly dilated, or even laid open, and the stone removed. If the stone has been arrested higher up it must be extracted by a direct incision through the walls of the urethra and down upon the nodule. If in the free (protractile) portion of the penis, that organ is to be withdrawn from its sheath until the nodule is exposed and can be incised. If behind the scrotum, the incision must be made in the median line between the thighs and directly over the nodule, the skin having been rendered tense by the fingers and thumb of the left hand. If the stone has been arrested in the intrapelvic portion of the urethra, the incision must be made beneath the anus and the calculus extracted with forceps, as in stone in the bladder. The wound in the urethra may be stitched up, and usually heals slowly but satisfactorily. Healing will be favored by washing two or three times daily with a solution of a teaspoonful of carbolic acid in a pint of water.
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