Perineal Litholapaxy in Children

Thus there are in the Punjab yearly about 250 operations for stone by cutting, and between 400 and 500 in the United Provinces. A very few of these are perineal litholapaxies. It. is difficult to say how they should be classified, as they involve both cutting and crushing. Doubtless the vast majority of the lateral lithotomies are cutting operations performed in children in those cases in which the stone is proved to be too large to be included in the grip of the largest 1 ithotrite which the urethra, will hold Why should the routine method in these circumstances be to remove the stone entire ? The mortality caused by pulling a stone through a practically non-elastic opening is a large one. In any stone over one inch in diameter the operation involves tearing and bruising of the tissues. Apart from experiment this is apparent from the length of time the wound takes to heal. It is to be remembered the perineal litholapaxy operation was first introduced in Sindh to cope with very large stones in adults. The same reasoning which lead to the advance in treat-