A non-surgical treatise on diseases of the prostate gland and adnexa . take into account the real cause of theobstruction and its sequences, or at least affects only asmall proportion of them. If the retention, cystitis, andtheir results were caused by a bar or a collar or otherobstruction at the lower portion of the vesical opening HYPERTROPHY OF THE PROSTATE. 133 only, the Bottini apparently would be the indicated oper-ation always, provided free drainage afterward could beinstituted to prevent septic infection. A catheter tiedinto the urethra, to my mind, is a brutal and painful relicof the
A non-surgical treatise on diseases of the prostate gland and adnexa . take into account the real cause of theobstruction and its sequences, or at least affects only asmall proportion of them. If the retention, cystitis, andtheir results were caused by a bar or a collar or otherobstruction at the lower portion of the vesical opening HYPERTROPHY OF THE PROSTATE. 133 only, the Bottini apparently would be the indicated oper-ation always, provided free drainage afterward could beinstituted to prevent septic infection. A catheter tiedinto the urethra, to my mind, is a brutal and painful relicof the dark ages of genito-urinary surgery. Most of thecases which have come under my observation, that hadbeen operated upon by the Bottini method, have been com-plete failures; in all of these, however, with the exceptionof one case, the operation has been contraindicated. Oneof these cases, I can recall, was reported at a meeting of amedical society as a remarkable cure, when in less thana week thereafter, I noticed his name in the death list,followed by uremic Fig. xx; Fig. XX. illustrates an instrument devised by theauthor for relieving this indurated enlargement at theneck of the bladder. It is similarly constructed to thatof the Bottini instrument, except that the cauterizing partis flat instead of a blade. It is not intended to cut, butsear the indurated surface, as illustrated. This operationis attended with practically no danger, and converts thehard resilient tissue into a soft granular surface, thatadmits the action of cataphoresis, and atrophy of theobstruction, without danger to life. In fact, it seldomrequires confinement of the patient to his room more thanone day. Many never discontinue work more than an houror two, but I always advise at least a days rest. Fig. XXI. shows the application of the cautery to theindurated third lobe. 134 PROSTATE GLAND AND ADNEXA. The technique of this operation is first to produce local-ized anesthesia of the prostatic urethra
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