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December 17, 1955

Suprapubic Prostatectomy with Primary Closure of the Bladder by an Original Method: Preparation, Technique, and Post-Operative Treatment

JAMA. 1955;159(16):1577. doi:10.1001/jama.1955.02960330077026

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Surgical treatment of prostatic obstruction has been variously modified since the first complete prostatectomy performed by Fuller about 75 years ago. The two methods widely used today, transurethral resection and retropubic prostatectomy, have been developed in the past decade. The operation described by Hryntschak is based on the suprapubic prostatectomy suggested by the Australian urologist, Harris, who advocated closure of the bladder immediately after prostatic enucleation. This method was tried by a number of urologists but was given up because of postoperative hemorrhage and the frequent occurrence of suprapubic fistulas. Hryntschak was impressed by Harris' theories and set out to develop a surgical technique that would obviate the postoperative complications. He succeeded in doing so, largely by compression of the periprostatic blood vessels through carefully adjusted sutures in the prostatic capsule and by perfecting a purse-string suture around the bladder incision, which rendered it watertight. These and other technical measures

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