GRADUAL EMPTYING OF THE OVERDISTENDED BLADDER

It is generally recognized that the removal of urine from a chronically overdistended bladder is often followed by untoward symptoms, or death. If the bladder is emptied rapidly and completely at one time, the sudden reduction of the intravesical pressure results in immediate congestion throughout the urinary tract, with resulting edema and hemorrhage, which may be so severe as completely to suppress renal function by increasing the pressure within the renal capsule to a point incompatible with glomerular and tubular function. Even though the process may not go on to complete suppression of urine, the congestion and edema make the urinary tract a fertile field for infection, a complication which is borne very poorly by this class of patients, and is the undoubted cause of many of the fatalities.O'Conor1 has shown that, coincident with emptying the bladder of residual urine, there is a decided fall in blood pressure.