It is generally conceded that, step by step, the operation of enucleation of the prostate from its capsule, whether performed suprapubically or perineally, has justly attained the recognized rank of a curative procedure for that urinary obstruction and destruction which is caused by benign enlargement of the gland.
It would add greatly to the "unification of the surgery of the world"— to use an expression of Howard A. Kelly—if a consensus of opinion could be taken on three points which can not but be vital to the future ready acceptance of this operation by the patient as well as by the profession.
My own experience, which, I may state, is both large and varied and dates from the time when I was taught prostatectomy by McGill of Leeds, in 1890, forces me to the conclusion that our suprapubic technic for prostatic enucleation is faulty in three directions, and these form
FENWICK EH. VITAL POINTS IN THE TECHNIC OF SUPRAPUBIC ENUCLEATION OF THE PROSTATE FOR BENIGN ENLARGEMENT OF THAT GLAND.. JAMA. 1906;XLVII(15):1151-1153. doi:10.1001/jama.1906.25210150007001c