Light and electron microscope studies were made on the transitional epithelium of the urinary bladder of rabbits. The change in the vesical epithelium was also observed in the urinary bladder which was artificially kept in the urine-filling or empty state. Moreover, the absorptive ability was examined by administrating the Indian ink into the urinary bladder. The results are as follows.
The superficial cells contain vesicles, vacuoles or swollen mitochondria and are characterized by incisions with various depths. In the cells in the middle layer, vesicles, interdigitation or Golgi apparatus can be observed. In this layer, the dark cells diffrent clearly from the surrounding cells in the electron density were recognized by the author. The basal cells are irregular in shape and their cell bodies and nuclei are small.
When the bladder was kept in the empty state by changing the urinary tract, the superficial layer was most severely affected. Both the incisions on the free surface and the large or small vacuoles already disappeared one week after the operation. The mitochondria in the cells of this layer swelled. The change in the cells of the middle and basal layer was less than that in the superficial cells.
In the experiments with use of the Indian ink, the vacuoles in various sizes were observed within the superfcial cells and the ink particles were seen in the intercellular space of this layer. The bladder which was maintained in the empty state showed no absorptive ability.

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One hundred and twenty-seven transurethral resections were performed on 114 patients with benign prostatic hypertrophy during the period between November 1959 and August 1963, at the Jikei University Hospital.
We have been using the modified Iglesias resectoscope, the sheath of which has a water control valve attached between the connecting tube and the spring catch lock so that one can control the valve very easily with the tip of the index finger.
The ages of the patients varied between 29 and 82 years; the average age at operation was 61.7 years.
Low spinal anesthesia or epidural anesthesia was employed in majority of the cases, though general anesthesia, venous anesthesia or generalized hypothermia was employed in some exceptional cases.
Urigal (cytal) was used in 65 cases as irrigating fluid, sterile distilled water in 44 cases, combination of sterile distilled water and 4% glucose in 14 cases, and combination of sterile distilled Water and urigal in 4 cases.
The biggest prostatic tissue resected weighed 68 grams, but the average weight was 10.5 grams.
The length of the time needed for the resecting procedure varied between 5 and 80 minuts; the average time was 40 minuts.
The average blood loss during the resecting procedure was about 133cc and average postoperative blood loss was about 22cc.
The venous blood specimens were taken before and immediately after the resecting procedure to examine the changes of the serum Na, K, Cl and BUN levels. The serum Na decreased 3.6mEq/L, K decreased 0.1mEq/L, Cl decreased 3mEq/L and only BUN remained unchanged.
The average term of postoperative indwelling catheter was 3.8 days and average length of hospitalization was 14 days.
The operative and postoperative complications consisted of 7 perforations of prostatic capsule, 5 meatal strictures, 4 epididymitis, 2 acute renal failures, 2 temporary urinary incontinences, an acute pneumonitis, a postoperative bladder neck contracture and many urinary infections.
One hundred and eight patients or 96.4% of the whole patients recovered well and showed improvement in urination.
There were two operative death or 1.75% of operative mortality in this series.
Though my experience is still limited and follow up period is not long enough, I feel that transurethral resection is the treatment of choice for the majority of patients with benign prostatic hypertrophy.

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