File:Studies on hypertrophy and cancer of the prostate (1906) (14782330694).jpg

Identifier: studiesonhypertr00youn (find matches)
Title: Studies on hypertrophy and cancer of the prostate
Year: 1906 (1900s)
Authors: Young, Hugh H., 1870-1945 Johns Hopkins Hospital
Subjects: Prostatic Hypertrophy Prostatic Neoplasms Fistula
Publisher: Baltimore, Johns Hopkins Press
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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the notch and furrow are obliterated. Theseminal vesicles cannot be reached. Cystoscopic.—The cystoscope was introduced through the suprapubicopening. The intravesical prostatic enlargement consisted of a huge mid-dle lobe which coalesced without intervening sulci with two large laterallobes, between which there was a deep sulcus in front. The ureters laybeneath the median lobe and could not be seen. An attempt was thenmade to cystoscope the bladder through the urethra, but the intravesical 170 Hugh H. Young. portion was so great that the instrument could not be passed over the topof it. The finger in the suprapubic wound showed that the end of thecystoscope lay in the space in front of the median lobe. Operation, May 30, 1903.—Ether. Perineal prostatectomy by the usualtechnique. The lateral lobes, which were very large, were removed eachin three large lobules. The median lobe was delivered into the left lat-eral cavity and enucleated vrith ease, without removing any of the mucous
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Fig. 41.—Large lateral and median lobes. Exact size. membrane which covered it. This lobe was 5 cm. long, 3i^ cm. wide, and2^2 cm. thick. The accompanying photograph shows the lobes in theirrelative position (Fig. 41). The urethra and ejaculatory ducts were pre-served intact. At the end of the operation a finger was inserted in thesuprapubic fistula and showed no intravesical prostatic enlargement, themucous membrane covering the same having contracted down so that thevesical neck felt almost normal in smoothness. The perineal wound was study of lJ+5 Cases of Perineal Prostatectomy. ITl closed as usual ^\-itli double catheter drain, and light packs for the lateralcavities. Infusion and continuous irrigation. The condition of the pa-tient at end of operation was good. Convalesceyice.—The patient reacted well. His highest temperature was101°, and there was very little hemorrhage. The gauze was not removedfrom the perineal wound until four weeks after the operation (the op-erator wa

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