. Surgery, its principles and practice . cases where thestone is more orless completely em-bedded in the pro-static substance thesuprapubic route a matter of fact,the perineal route ispreferable in mostcases. The prostateshould be exposedas for a perinealprostatectomy, andopened either upona grooved staff or upon a prostatic tractor which has previously been inserted. In youngpatients the calculi are usually not great in number and it is not neces-sary to remove gland tissue. The multiple seed calculi which are foundscattered throughout the gland are almost al
. Surgery, its principles and practice . cases where thestone is more orless completely em-bedded in the pro-static substance thesuprapubic route a matter of fact,the perineal route ispreferable in mostcases. The prostateshould be exposedas for a perinealprostatectomy, andopened either upona grooved staff or upon a prostatic tractor which has previously been inserted. In youngpatients the calculi are usually not great in number and it is not neces-sary to remove gland tissue. The multiple seed calculi which are foundscattered throughout the gland are almost always associated with pros-tatic hypertrophy or obstructive prostatitis, and prostatectomy is indi-cated, being the simplest way of removing the calculi. The operativeprocedures have been discussed at length in vols, xiii and xiv of theJohns Hopkins Hospital Reports. Acute Prostatitis.—Acute prostatitis has been classified by Albar-ran as follows: I. Glandular. [ Parenchymatous. \ Abscess. L Periprostatic Fig. 210.—Removal op Calculus. 388 SURGERY OF THE PROSTATE. By glandular prostatitis is meant inflammation of the prostate whichinvolves only the glands themselves and in which the periglandulartissue does not take part in the inflammatory process. In the parenchy-matous form both glandular and interstitial tissue is involved. Glandular Prostatitis.—This is taken to mean the simplest form ofacute prostatitis, in which there is merely a proliferation of epitheliumwith desquamation and marked diapedesis. In most cases it is due toan invasion of the gonococcus into the depths of the prostatic gland. Inmild cases only that portion of the prostate immediately around the ure-thra is involved. In more advanced cases the larger part of the prostatemay be involved, but in some cases very little swelling of the prostateand few symptoms are produced. Goldberg has employed the name ofprostatitis endoglandularis, and as there is considerable objection to
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