A CASE
OF
PROSTATECTOMY
FOR THE
RADICAL CURE OF PROSTATIC STONE. By Arthur Powell, m, ch., Kalline, Cachar, The very satisfactory result in the case now recorded gives me confidence in recommending the same procedure, especially when the patient lives at a distance from surgical aid, and is liable to frequent attacks of obstruction of the urethra by prostatic calculi. The orthodox treatment, according to Erichsen, is expectanc}', merely removing the stones as " If the calculi be small they cause retention. and very numerous, it will be wiser " not to have recourse to operation ( lithotomy ) " which could not remove the whole of the concretions." The patient, a Mussalman, cet. 50, had for seven years suffered at frequent intervals from retention of urine, due to blocking of the urethra by prostatic calculi. He had been under the
60
.
INDIAN MEDICAL GAZETTE.
of many surgeons and, as the result of repeated slittings of the opening of the urethra, presented the appearance of an artificial hypospadias with a tight stricture at the orifice of the
care
tube.
Failing to deliver with forceps a stone just inside this meatus, I was loathe to further mutilate the penis, so pushed the urethral stones back into the bladder, performed lateral lithotomy, and removed all the loose stones. There were still in the many embedded substance of the prostate. With curved scissors, sharp spoon, and forceps, but chiefly with the spoon, using the finger as counter-pressure, I cut and tore away, bit by bit, the prostate with the contained stones. Haemorrhage was free but not as great as I expected, and was easily restrained " by hot water and a petticoat." The stones were 42 in number and composed of lime-phosphate. The patient left hospital in seventeen days, the wound being soundly healed. Nine months later he reported himself in health. He had had no further urinary trouble, and his condition presented a striking contrast to his previous continued melancholy from anticipation of his frequent and painful attacks of retention, and the operations necessary for its relief. The lateral cystotomy was chosen in preference to the median, as the former allows of a freer skin-incision and the more secure application of the petticoat to restrain haemorrhage. j
perfect
[Feb.
1898.
OF
PROSTATECTOMY
FOR THE
RADICAL CURE OF PROSTATIC STONE. By Arthur Powell, m, ch., Kalline, Cachar, The very satisfactory result in the case now recorded gives me confidence in recommending the same procedure, especially when the patient lives at a distance from surgical aid, and is liable to frequent attacks of obstruction of the urethra by prostatic calculi. The orthodox treatment, according to Erichsen, is expectanc}', merely removing the stones as " If the calculi be small they cause retention. and very numerous, it will be wiser " not to have recourse to operation ( lithotomy ) " which could not remove the whole of the concretions." The patient, a Mussalman, cet. 50, had for seven years suffered at frequent intervals from retention of urine, due to blocking of the urethra by prostatic calculi. He had been under the
60
.
INDIAN MEDICAL GAZETTE.
of many surgeons and, as the result of repeated slittings of the opening of the urethra, presented the appearance of an artificial hypospadias with a tight stricture at the orifice of the
care
tube.
Failing to deliver with forceps a stone just inside this meatus, I was loathe to further mutilate the penis, so pushed the urethral stones back into the bladder, performed lateral lithotomy, and removed all the loose stones. There were still in the many embedded substance of the prostate. With curved scissors, sharp spoon, and forceps, but chiefly with the spoon, using the finger as counter-pressure, I cut and tore away, bit by bit, the prostate with the contained stones. Haemorrhage was free but not as great as I expected, and was easily restrained " by hot water and a petticoat." The stones were 42 in number and composed of lime-phosphate. The patient left hospital in seventeen days, the wound being soundly healed. Nine months later he reported himself in health. He had had no further urinary trouble, and his condition presented a striking contrast to his previous continued melancholy from anticipation of his frequent and painful attacks of retention, and the operations necessary for its relief. The lateral cystotomy was chosen in preference to the median, as the former allows of a freer skin-incision and the more secure application of the petticoat to restrain haemorrhage. j
perfect
[Feb.
1898.
