Remarks on cancer of the prostate and the selection of cases for suprapubic prostatectomy : delivered at the Medical Graduates' College and Polyclinic, June 3, 1903 / by Reginald Harrison.

  • Harrison, Reginald, 1837-1908.
Date:
1903
Catalogue details

Licence: In copyright

Credit: Remarks on cancer of the prostate and the selection of cases for suprapubic prostatectomy : delivered at the Medical Graduates' College and Polyclinic, June 3, 1903 / by Reginald Harrison. 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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    between hypertrophy and carcinoma may thus be stated. Carcinoma of the prostate, in by far the greater pro- portion of cases, is of a hard and slow-growing nature, closely resembling scirrhus of the breast, both micros- copically and to the naked eye. As a rule there is not very much intravesical projection of the prostate in these cases, and what there is is of an uneven and irregular outline. On the other hand, the large, soft adenomatous prostate presents, as a rule, a considerable enlargement into the bladder cavity with a smooth, rounded surface. The most general arrangement of these adenomatous masses are these :— (1) As a collar-like general enlargement of the prostatic ring encircling the prostatic portion of the urethra. (2) As an enlargement of the two lateral lobes, thus squeezing and flattening the urethra from side to side, the greatest diameter of that passage thus becoming vertical. (3) An enlargement of the posterior or middle lobe, either as a sessile, rounded swelling under the mucous membrane of the apex of the trigone, or with a thick pedicle, thus closely resembling a fibro-papilloma in appearance. (4) Or there may be a combination of any or all of the preceding varieties. It is thus obvious that the cystoscopic appearance of the adenomatous prostate varies very much according to the direction of the growth. Usually the contour can be made out fairly accurately, and the observer can say that he has to deal with a lateral lobe enlargement, a collar-like enlargement with projecting middle lobe, or an enlargement mainly of a pedunculated nature. The importance of this is obvious, for in the last-mentioned case a simple twisting off of the pedunculated middle lobe would be sufficient to relieve all symptoms, as I shall presently show, and is a much less serious pro- ceeding than removing the whole of the enlarged gland. It should also be noted that the mucous membrane covering the very large adenomatous masses is often of a peculiarly glistening character, and sometimes presents little cyst-like swellings, which, when viewed in profile, are semi-translucent. I have not observed this appear- ance in cases which eventually turned out to be car- cinoma.