. Surgery, its principles and practice . oved the clamps,but allowed themto emerge with thegauze packing fromthe anterior angleof the wound (theywere removedtwenty-four hourslater). If carefulattention has been given to the prevention of hemorrhage and an in-fusion has been begun early in the operation, there should be little orno shock. The management of the convalescence is much the same as aftersimple prostatectomy, an abundance of water being indicated, the patientup in a wheel-chair in two or three days, at the end of which time thegauze packing should be removed. The retained, catheter h
. Surgery, its principles and practice . oved the clamps,but allowed themto emerge with thegauze packing fromthe anterior angleof the wound (theywere removedtwenty-four hourslater). If carefulattention has been given to the prevention of hemorrhage and an in-fusion has been begun early in the operation, there should be little orno shock. The management of the convalescence is much the same as aftersimple prostatectomy, an abundance of water being indicated, the patientup in a wheel-chair in two or three days, at the end of which time thegauze packing should be removed. The retained, catheter had betterremain for a week. In all of my cases there has been leakage of urinethrough the perineum, but often not until several days after the operation,and in all cases the perineal wound has finally closed without the use of asecond retained catheter or urethral dilatation with sounds. No strictureshave resulted, and although incontinence of urine by day has generallybeen present, this can be taken care of by means of a rubber Fig. 243.—Exposure and Division of Trigone. 468 SURGERY OF THE PROSTATE. Results.—While it is too early to draw positive conclusions and thenumber of cases (six) is too small, it may be stated that three cases arestill alive and well, one two years and four months, one two years andthree months, and one one year and ten months after the operation, andthat one patient lived in comparative comfort for nine months and thendied of something- else. One patient died of nephritis seven weeks afterthe operation, and the autopsy showed that the carcinoma had been com-pletely removed. The sixth case died of operative shock, and autopsyshowed that the cancer had passed directly from the prostate into theperitoneum, which was extensively invaded. This could not be deter-mined before operation, and as the bladder and upper portion of the sem-inal vesicles werefree from diseasethe radical opera-tion was carriedout. It seemsprobable, in viewof the absence
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