Objective To determine, in an in vitro study, the pressure then placed in the centre of the cuC lumen, rotated by 360°and the pressure continuously recorded. inside the AMS 800 (American Medical Systems, USA) sphincter placed around porcine intestine and to correResults The cuC occluded the lumen by creating a 'triplecushion' eCect. The fluid retention pressure was #49% late this with the pressure retention for liquids, in an attempt to explain the increased sensitivity of bowel of the cuC pressure. There were directional diCerences in the pressure measured inside the bowel lumen. The to ischaemic injury when the artificial urinary sphincter is used around bowel neo-urethral segments.pressure was also disproportionately higher inside the cuC folds than in the centre of the sphincter, and Materials and methods Segments of porcine intestine were placed in a specially designed mechanical jig and increased rapidly with inflation of the cuC. Conclusion The thin wall of the bowel may 'crenate' an AMS 800 sphincter placed around the segment. The device was inflated by injecting water and the inside the high-pressure areas in the cuC folds and this may explain the increased sensitivity of bowel to cuC pressure measured. Water was infused into the bowel and the pressure at which leakage occurred ischaemic injury in such cases.

These data show a high incidence of MDA as the treatment of choice for chronic anal fissure amongst consultant surgeons in the West of Scotland. The implications of such a practice are discussed.

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urine was ordered to be drawn off and the bladder to be washed out with a solution of Condy's fluid daily, using a soft catheter; and it was found on passing a No. 10 catheter that there was no return of the former disease, stricture. The patient, of course, remained in bed, taking milk diet only, and on Nov. 9th he stated that he was much more comfortable; the mucus in the urine had considerably diminished, and there was only a small staining of blood; the tongue was clean, and the pulse 72; the bowels comfortably open. On Nov. 13th the notes suggest that the patient was rapidly improving, for the pain was subsiding. He expressed himself as greatly relieved. Tongue clean, temperature normal, and but little blood in the urine. This apparent improvement can only be referred to his complete rest in bed. On the 15th, Mr. Norton's fourth visit, he found the patient complaining of great pain, aching and lancinating, in both loins and over thepubes; the pelvic growth had very distinctly

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