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September 27, 1958


Author Affiliations

Lexington, Ky.

Associate Professor of Urology, University of Louisville School of Medicine (Dr. Ray), and Resident in Urology, St. Joseph Hospital (Dr. Cervantes).

JAMA. 1958;168(4):395-398. doi:10.1001/jama.1958.03000040031007

The physician in general practice is important in both the preoperative diagnosis and the postoperative care of the patients with obstruction of the neck of the bladder. The diagnosis is not always easy, for neither the degree of difficulty in urination nor the size of the prostate as judged by rectal examination is a completely reliable criterion for the need of surgery. The author believes therefore that endoscopic examinations should be done oftener than in the past. Experience with 2,160 men who underwent transurethral resection for prostatic hypertrophy during the 12-year period from 1946 to 1957 inclusive showed that the home physician should be prepared for some of the complications that may occur after the patient has left the hospital. These include extravasation of urine, hemorrhage, retention, incontinence, pyuria, stricture of the urethra, and contracture of the vesical neck. Pus, with or without bacteria, usually persists in the urine for several months. The indiscriminate use of antibiotics is to be discouraged. Unless the pyuria is accompanied by other painful or disquieting symptoms, no great effort should be made to eliminate it, since this is impossible until wound healing is complete.