Clinical aspect of the enlarged prostate : with a review of 67 cases / by James N. Vander Veer.

  • Vander Veer, James N., 1877-1937.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Clinical aspect of the enlarged prostate : with a review of 67 cases / by James N. Vander Veer. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/14
    among the diagnostic instruments at hand), the condition of the bladder, the hypertrophy of the muscular tissue and the hypertrophy of the gland itself can be noted. This last examination, of course, should only be made by those skilled in the art, because the ureteral orifices are at times so widely dilated from the previous retention, and also because of the fact that the cystitis may be distinctly localized in the bladder, and the kidneys be uninvolved, and the introduction of a new series of bacteria may cause a lighting up of the old infection, as well as giving new families a chance to grow. Lastly, we should not fail to note the amount of urine voided in 24 hours, together with a com- plete examination of the same in every detail, that we may be able to prognose regarding the results of an operation. In general, the method of operating upon these cases has been that of the perineal route, giving means of entrance into the bladder through the posterior urethra, and the introduction of Young’s tractor. The prostate has been drawn downward to the engaging finger, and thereby enucleated. This has necessitated what we have been pleased to call—a deal of finger work, and one which has given great satisfaction. There is, however, one great drawback, from the fact that the finger may be too short and that the hemorrhage may be severe, while the danger to the rectum is, of course, not to be disregarded. Then, too. one occasionally sees a patient where the perineum is exceedingly short, and in such cases there is an embarrassment in not being able to enjoy a satisfactory perineal incision. Following the enucleation of the prostate, we