Note 74 — Chapter LVI · THE MALE GENITAL ORGANS.

In the treatment of infections of the seminal vesicles, particularly those of gonorrheal origin, Belfield has advised irrigation and drainage of the same through the vas deferens. He brings this up against the skin of the scrotum, where it is easily identified, and then, through a one to two-inch incision, made under local anesthesia, exposes the vas, into which the blunted end of a hypodermic-syringe needle may be introduced, by means of which a solution of any desired agent may be injected. This being thrown in the direction of the seminal current passes up through the vas and into the vesicle. He has even recommended in certain cases to attach the vas to the skin by a fine silkworm suture, and in this way to make a minute fistula, which can be used for the purpose as long as may be necessary. He considers the method invaluable in the treatment of chronic gonorrheal vesiculitis or the chronic infections of the seminal canal in the elderly, which are often mistaken for enlarged prostate, as well as in cases of recurrent epididymitis resulting from repeated invasion from behind. Thus he has seen benefit follow, in tuberculosis of the epididymis, from irrigation with carbolic solution. The amount injected into the vesicle should never exceed 2 Cc.