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February 17, 1917

PRELIMINARY TREATMENT FOR PROSTATECTOMY IN UNFAVORABLE CASES

Author Affiliations

BALTIMORE

From the James Buchanan Brady Urological Institute, Johns Hopkins Hospital.

JAMA. 1917;LXVIII(7):526-530. doi:10.1001/jama.1917.04270020190008
Abstract

Twenty years ago the mortality for prostatectomy was estimated at 20 per cent. Today in some clinics, it is less than 4 per cent. What has brought about this marvelous change? More accurate diagnosis and better operative technic have, of course, done much to reduce the mortality—the substitution of accurate operations, under visual control, for destructive procedures done in the dark, being one of the principal factors.

But much of the early mortality was due to complications, resulting from conditions existing before operation which were overlooked or neglected. In 1898, one of us operated on a patient who came to the hospital in severe uremia. A catheter could not be passed, suprapubic drainage was all that could be done, and the drainage afforded worked a seeming miracle. In a few days consciousness returned, and within a few weeks prostatectomy was carried out without difficulty and with success. Since

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