. Studies on hypertrophy and cancer of the prostate. fficulty being encountered in freeing the rectum fromthe prostate. The lateral lobes, which were moderately hypertrophied,were easily enucleated and a fairly large median lobe was removedthrough one of the lateral cavities with ease by means of the tractor. 200 Hugh H. Young. With the finger a small pedunculated subcervical median lobe was re-moved (Fig. 42). A small tear was made in the urethra in so doing, butthe floor of the urethra and ejaculatory ducts were preserved intact. Thewound was closed as usual, with exception that the rectum w
. Studies on hypertrophy and cancer of the prostate. fficulty being encountered in freeing the rectum fromthe prostate. The lateral lobes, which were moderately hypertrophied,were easily enucleated and a fairly large median lobe was removedthrough one of the lateral cavities with ease by means of the tractor. 200 Hugh H. Young. With the finger a small pedunculated subcervical median lobe was re-moved (Fig. 42). A small tear was made in the urethra in so doing, butthe floor of the urethra and ejaculatory ducts were preserved intact. Thewound was closed as usual, with exception that the rectum was notexamined and the levator ani muscles were not drawn together (up tothis time this was not done as a routine procedure, although it had beendone in the very first operation). Convalescence.—The patient stood the operation well, pulse at the endbeing 94. Continuous irrigation was kept up for four days, when thegauze and tubes were removed. Two days later, during a bowel move-ment, feces escaped through the perineal wound. On the day following. Fig. 42.—Lateral lobes, moderate median bar, small pedunculated sub-cervical medium lobe. the operation the patient complained greatly of abdominal pain and laterpain in the back. He was given calomel, and 400 cc. salt solution, withpotassium citrate as an enema to be retained, this was repeated threetimes a day for at least four days, a large rectal tube being used eachtime. Remark.—In reviewing the case there seems to be no reason for thistreatment as the patient was not nauseated, had no fever, temperature be-ing normal, and his condition was excellent, with the exception of pain inthe abdomen. It is possible that the traumatism produced by the frequentintroduction of the large rectal tube caused necrosis of the rectal walladjacent to the wound and led to the fistula, but as the operator did notexamine the rectum after the operation and did not cover it by approxi- study of lJf5 Cases of ?Perineal Frostatectomy. 201 mating th
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfistula, bookyear1906
