Double Lithotome Cache by Tiemann

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A circa 1850 double lithotome cache used to remove bladder stones. Made from polished and blued steel with a horn handle in a crosshatched harlequin design.

Two blades with blunt ends lie within and are concealed by the body of the lithotome, protecting any unplanned trauma to the urethral canal. The instrument was not introduced per urethra but via a lateral perineal incision and would be aligned with a grooved catheter (inserted beforehand) at the distal urethra. When in place the handle was depressed, opening the two blades which when pulled back would divide the neck of the bladder and both lateral lobes of the prostate. This would also cause a small part of the membranous urethra to be cut “after the fashion of a pen”. The stone was them removed with forceps.

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