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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    in the latter position it may be interred that the seminal vesicles retained their normal relation at the upper part of the prostate. When, however, the torn ducts are found low down, the seminal vehicles have probably been stripped from the bladder base and form a posterior relation of the prostate in the manner already described. IY.—THE PARTS LEFT BEHIND AFTER THE OPERATION OF PROSTATECTOMY. The material collected for this part of the investigation con- sisted of four specimens. Death occurred in these cases in from nine hours to fifteen days after the operation. Three of the specimens were removed from the bodies in the following- manner: The bladder and rectum were first detached, together with the levatores ani, by cutting as close as possible to the pelvic wall. A median incision was then made in the perineum over the bulb and carried back around the anus. The bulb, the perineal muscles, the triangular fascia, and the anus were then dissected from the pelvic outlet, and the whole mass drawn up through the abdominal wound. The bladder and prostatic sheath were then opened along the middle line anteriorly. The remaining specimen was sent to me after removal from the body. In specimens III. and IV. the presence of a nodule of car- cinoma outside the sheath in the former, and of carcinomatous deposit in the lymphatic glands of the pelvis in the latter, shewed that prostatectomy had been performed upon carcino- matous prostates. These specimens might therefore be put aside, were it not that they proved useful for dissection and corroborated certain of the anatomical points found in the others. I shall describe one specimen in detail and merely refer to differences in regard to the others. At the upper part of this specimen is the trabeculated bladder (Fig. 8, a), and below this the cavity from which the prostate was removed (Fig. 8, n d) . The vesical sphincter is a well-defined muscular band (Fig. 8, c) and surrounds an aperture of considerable area. This