An American text-book of genito-urinary diseases, syphilis and diseases of the skin . a perineal incision, or through the bladderafter performing the usual suprapubic cystotomy, or, as has been recom-mended by Belfield and others, by a combination of these two. Opinions aredivided regarding the relative value of these procedures. Woolsey3 has 1 Amer. Surg. Assn, 1885. 2 Med. Press and Oirc, Jan., 1892. 3 Journ. of Cut. and Dis., July, 1895. PBOSTA TECTOMY. 301 recently made an exhaustive study of the choice of operation in these difference in the views of the various write
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . a perineal incision, or through the bladderafter performing the usual suprapubic cystotomy, or, as has been recom-mended by Belfield and others, by a combination of these two. Opinions aredivided regarding the relative value of these procedures. Woolsey3 has 1 Amer. Surg. Assn, 1885. 2 Med. Press and Oirc, Jan., 1892. 3 Journ. of Cut. and Dis., July, 1895. PBOSTA TECTOMY. 301 recently made an exhaustive study of the choice of operation in these difference in the views of the various writers on this subject is due tothe particular conception of the underlying conditions upon which dependsthe urinary obstruction in enlargement of the prostate. McGill, for example,whose efforts succeeded in placing prominently before the profession thesuprapubic operation, believed (1) that prostatic enlargements which giverise to urinary symptoms are intravesical and not rectal, and (2) that reten-tion is caused by a valve-like action of the intravesical prostate, the urethral £x^. Fig. 92.—Civiales kiotome: a, open; o, closed. orifice being closed more or less completely by the contraction of the bladderon its It is clear that if these propositions were true of everycase, the suprapubic route should always be selected. Watson2 found among30 specimens 28 in which the principal hindrance was an outgrowth at thevesical outlet, and in 10 cases this was the sole source of obstruction. On the other hand, von Dittel claims that hypertrophy of the middlelobe is usually accompanied by a more or less considerable enlargement of
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Keywords: ., bookcentury1800, bookdecade1890, booksubject, booksubjectsyphilis
