operative surgery insuch cases the choice must be made be tween perineal section without a guide and suprapubic puncture combined with retrograde catheterization to be atonce followed by perineal section the operatioi by direct incision suprapubic cystotomyas alexan der truly says the operation may be performed under local cocain anasthe sia in cases where a general anjesthetic is inadvisable the pubis is shavedand the skin scrubbed and disinfected an incision about an inch and a halflong is made in the middle line beginning at the symphysis pubis fig1312 the skin and fascife 2angp86.jpg from disección perineal femenina View Photo