. Studies on hypertrophy and cancer of the prostate. side view ofa specimen of considerable hypertrophy of the right lateral lobe. Theaponeurosis of Denonvilliers, which is firmly attached to the posteriorsurface of the seminal vesicles and of the prostate below their en-trance, and which binds the two together closely, may be responsiblefor the upward growth of the hypertrophied prostate and the result-ant low insertion of the ducts into the posterior surface. The results of this study of the course of the ejaculatory ducts maybe thus summarized: 16 Hugh H. Young. In the normal prostate the e
. Studies on hypertrophy and cancer of the prostate. side view ofa specimen of considerable hypertrophy of the right lateral lobe. Theaponeurosis of Denonvilliers, which is firmly attached to the posteriorsurface of the seminal vesicles and of the prostate below their en-trance, and which binds the two together closely, may be responsiblefor the upward growth of the hypertrophied prostate and the result-ant low insertion of the ducts into the posterior surface. The results of this study of the course of the ejaculatory ducts maybe thus summarized: 16 Hugh H. Young. In the normal prostate the ejaculatory ducts lie for the most partjust beneath the posterior capsule, considerably below the level ofthe vesical neck, and are separated from it by the prespermatic groupof glands. In the hypertrophied prostate the same statements are true, theonly difference being that the ducts enter relatively lower down, andthe vesical neck is separated from them by much more tissue, especi-ally if the prespermatic group of glands have taken on growth with. Fig. 9.—iThe inverted V cutaneous incision. the resulting median lobe enlargement, in which case the vesical orificeis lifted high up above the level of the ducts. The prostatic tissue im-mediately adjacent to the ducts is beneath the urethra and plays nopart in the obstruction, which is caused entirely by the lateral andmedian enlargements, both of which are well above the ejaculatoryduets. The measures which I have adopted to preserve the integrity of theejaculatory ducts and sexual puissance of the patient I will take upa little later. study of lJf5 Cases of Perineal Prostatectomy. 17 TECHXIC OP THE OPEEATION. Position of the patient.—The exaggerated dorsal lithotomy positionis the most satisfactory. The perineal board of the Halsted table isadmirably suited for this purpose. The perineum should be so ele-vated that it is almost parallel with the floor. Before placing thepatient on the table a No. 24F sound, to be used as a gu
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfistula, bookyear1906
