The authors on the 24 cases of abscess of the prostata on which the intra-rectal surgical operation was applied, all occurring in the Akutsu Hospital, Tokyo. The following are the conclusions:-
(1) Early stages of abscess of the prostata should not be operated on by this method, but such a case as the abscess adheased to the rectal mucous with the focus situating superficially, after a careful observations on the pyrexia and processes of urenal turbidity, difficulty of micturition or aneurea and the clinical findings of the prostatic region by palpitation is indicated.
(2) Before the operation, the rectal contents are removed as clearly as possible, the position of pus is ascertained by meana of a trochar and then the rectal mucous is cut open perpendiculary along the trochar with a sharp edged knife. The cut is made deep enough to reach pus, when the operation wound is widened with a blunt knife wide enough to let out the entire pus. Then the operation would is closed tightly with a piece of gauze in such a manner as to protect the submucous tissues from contaminating by the pus. When the cut wound is completely covered by a growth of granulation tissues, which takes plaee usually after 4-7 days from the operation, the gauze is clearly removed. Then the operation wound is left by itself to heal up by natural process. Nearly 100% of the 24 operatien cases had all a good prognosis. The cases caused by gonococci usually healed after 3 to 7 weeks of the operation.
Post-operative involvements occurred in a few instance and they were very slight if any. Rectal gonorrhoea, urinary fistula, periprostatic phlegmon and the like did not develop in any cases.
In short, it many be said that no dangerous effects will develop after the rectal operation as generally apprehended, and the method is more simple than the operation through the perineal region. moreover a very satisfactory results could be had by this method of operatiön.
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