Clinical lectures on the surgical diseases of the urinary organs . > shows the structure ol the prostate and: >unding part nothing thai 1 i an call to mind that illustrates simply ibly the composition of the prostate and its coverings than an orange. Ii we imagine the edible portion oi an orange < omp i •i I ments only in itead .< ral, with the septum betwei n them pla< ed vertically, ii and homely illustration oi the foi mat in of i trong fibi • which covei the OPERATION OF TOTAL ENUCLEATION OF PROSTATE in segments of the orange, and which is intimately connectedwith the pulp,
Clinical lectures on the surgical diseases of the urinary organs . > shows the structure ol the prostate and: >unding part nothing thai 1 i an call to mind that illustrates simply ibly the composition of the prostate and its coverings than an orange. Ii we imagine the edible portion oi an orange < omp i •i I ments only in itead .< ral, with the septum betwei n them pla< ed vertically, ii and homely illustration oi the foi mat in of i trong fibi • which covei the OPERATION OF TOTAL ENUCLEATION OF PROSTATE in segments of the orange, and which is intimately connectedwith the pulp, represents the true capsule of the prostate, thetwo segments or halves of the orange being represented bythe two lobes. Further, the rind of the orange outside allrepresents the outer capsule or prostatic sheath formed bythe recto-vesical fascia. And here let me remark that in the operation that I shallpresently set forth, it is this inner or true capsule as above Anterior Commissure Lilt Lobe RigktLobe Vrethra m Plane 0/Separation. —. fern tf „ Prostatic Plexus. }Ste&tk — Plane of Separation tjatoUtory Ducts Fig. 47.—Diagrammatic View of Coronal Section of Prostateand Surrounding Sheath. described that is removed, the outer capsule or sheath beingleft behind, thus preventing infiltration of urine into thecellular tissues of the pelvis. The text-books, as a rule,drew no distinction between the two separate coverings ofthe prostate, treating them both combined, or the outer oneonly, as the capsule. To persons brought up in this schoolof thought and teaching my operation must at first sightnecessarily have appeared impossible. In most, if not in all, cases of enlargement of the prostate ii2 OPERATIOX OF TOTAL ENUCLEATION OF PROSTATE of declining life (cancer being excluded) the overgrowth isadenomatous in character, numerous encapsuled adenomatous tumours being found embedded within the substance of thelobes, and frequently protruding on their surfa
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Keywords: ., bookcentury1900, bookdecade1900, bookpublishernewyorkwilliamwood
