The surgical anatomy of the operation of suprapubic prostatectomy / by J.W. Thomson Walker.

  • Thomson-Walker, J. W. (John William), 1871-1937.
Date:
1905
Catalogue details

Licence: In copyright

Credit: The surgical anatomy of the operation of suprapubic prostatectomy / by J.W. Thomson Walker. 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.

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    The capsule is composed of densely-packed layers of unstriped muscle-fibre (Fig. 5, b). The fibres are long and- their charac- teristic nuclei are well stained and distinct. Here and tlieie a blood-vessel is found, and this is usually surrounded by an area of round cell infiltration (Fig. 5, c). Some of these ves- sels shew hyaline changes in their walls. The peiivasculai round cell infiltration may be found in lines between the mus- cular bundles, and sometimes resembles compressed gland tubules. At some part of the capsule there is not infrequently found one or several flattened gland tubules embedded among the layers of non-striped muscle. I have looked for an explana- tion of these gland tubules in the normal gland, and have found that the capsule here varies greatly in thickness, and at some parts gland tubules approach very near the surface (Fig. 1, m). It seems likely that these more superficial gland tubules may be caught up in the capsule and compressed as the prostate enlarges. Attached to the capsule a little to the left of the middle line is a mass of striped muscle-fibres (Fig. 6, a). The fibres are separated from one another by loose areolar tissue. In the capsule isolated striped muscle-fibres are also found lying em- bedded here and there among the layers of unstriped muscle (Fig. 7, a). The tuft of striped muscle on the front of the cap- sule corresponds to the vertical band of torn fibres described on the anterior surface of the specimen. This represents the layer of striped muscle which has been described lying between the capsule and the sheath of the normal organ. The striped fibres lying in the capsule are, I believe, the remains of these fibres which are present in the anterior commissure and capsule of the normal prostate. It is noteworthy that those on the front of the capsule are embedded in areolar tissue, while those in the capsule lie among the non-striped muscle tissue. On the front of the capsule in the neighbourhood of the tuft of striped muscle a few medullated nerve-fibres are found. In my sections of normal prostates I have not found medul- lated nerve-fibres in the capsule or stroma of the gland, although they are plentiful in the sheath; nor have I found in the literature any description of medullated nerve-fibres piercing the capsule of the prostate. It would appear, therefore, that these nerve-fibres must have been torn from the sheath during the enucleation. c 2