The subject of treatment of hypertrophy of the prostate can be reduced to very simple terms by putting down at the outset the three following statements as facts and letting them form a basis for a discussion. I doubt whether there will be any one who will dispute them :
1. The enlarged prostate produces trouble only when it causes obstruction at the bladder neck.
2. The degree of obstruction is not in relation to the size of the gland but rather to the location and arrangement of the enlarged portion.
3. Obstruction is caused not by the entire enlarged portion but by enlargement in certain localities and certain directions.
In figure 1 is shown a cystogram of an enormously enlarged prostate that is causing the patient no trouble whatever, while figure 2 shows a comparatively small gland that is producing almost the maximum trouble.
If the foregoing statements are
Alcock NG. PROSTATIC HYPERTROPHY: CLINICAL LECTURE AT CLEVELAND SESSION. JAMA. 1935;104(9):734–738. doi:10.1001/jama.1935.92760090002012
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