本教室22年間の恥骨後式前立腺摘出術の成績

Abstract

We have conducted 315 prostatectomies(retropubic after Millin 182 cases, retropubic by longitudinal capsular or vesicocapsular incision 116 and suprapubic after Freyer 9) during 22 years from the beginning of 1953 to the end of 1974. Herein, the results of the above mentioned two methods of retropubic prostatectomies are comparatively evaluated. Further, the results in the aged (eighties), azotemic and hyperglycemic patients are discussed along with the retrospection of the dead. While from the operation time and blood loss the longitudinal or vesico-capsular incision seems to prefer to the transverse one, from the disappearance of the postoperative urinary turbidity (pyuria) and cure of the operation wound the matter is reversed. The postoperative urinary infection was so stubborn that 60 days after operation 111 at most 38.5% (Millin's original) and 28.8% (another) of cases were required to be cleared. This, we think, depends very much on the states of the dead space remaining after prostatectomy (delayed shrinkage, irregularity of the wall, pouch formation etc.). Each of the high age, azotaemia, diabetes, latent heart disturbance by itself alone does not put the patient in danger. When two or three complications come together the prognosis is prone to be worse. Retrospection of the dead warns against the massive operative bleeding, decubitus and pyelonephritis and hasty operation in the unreasonable general conditons.