In man, the age at which obstructive changes in the prostate occur is often characterized by degenerative lesions in other parts of the body. In no organ or group of organs are these lesions of more importance than in the cardiovascular system. The heart may be so severely damaged that a very slight additional load will induce complete heart failure, or it may be only partially efficient, in which case the enfeebled circulation will affect unfavorably the function of other organs, such as the brain and the kidneys. The diminished activity of these organs will react again on the heart, thus establishing a vicious circle which ends in death. Prostatic obstruction in itself may augment the damage already present in the cardiovascular system. Pain, anxiety and loss of sleep impose on the heart a very real burden. Unquestionably the toxemia attendant on renal insufficiency has a deleterious effect on the
SMITH GG. THE CIRCULATION AS A FACTOR IN PROSTATIC SURGERY. JAMA. 1927;89(12):925–928. doi:10.1001/jama.1927.02690120001001
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