The prognosis necessarily depends on the nature of the tumour, but as it is impossible to determine this point before extirpation, the prognosis should always be regarded as very grave.
Treatment. Whatever the nature of the tumour, ablation is advisable. If it is of a benign character, recovery may be complete and permanent, but if it is malignant, generalisation will rapidly ensue. Before interfering surgically, however, it is essential to examine the inguinal, pelvic, and sublumbar lymphatic glands, to make sure that they are not affected. If they prove to be already invaded, an operation should be avoided.
Fig. 240.—Roof of the neck of the bladder and first part of the urethra (internal surface). 1, Orifice of the ureter; 2, urethra at a point beyond the urethral valve; 3, submucous erectile tissue; 4, urethral sphincter; 5, vesiculæ seminales; 6, veru montanum; 7, orifices of the vesiculæ seminales; 8, orifice of the vas deferens; 9, orifices of the prostate; 10, urethral valve, showing on its free margin the point-like openings of the ducts of Cowper’s gland. (After Barrier.)
Even despite such precautions and the apparent absence of any glandular infection, operation may be followed by generalisation in a few months, although for a short time the condition may seem to have greatly improved. No special indications need be given beyond those suggested as necessary in dealing with all kinds of tumours, whatever their nature.
The skin should be freely divided, that the tumour may be thoroughly dissected out and no fragments be overlooked. The mass of the tumour having been dissected free, the écraseur is applied to the pedicle or the cord. Enucleation of the tumour may be very difficult on account of the presence of numerous ramifications or attachments, but the closest attention must be given to removing every fragment if a fresh local growth is to be avoided. In the event of fragments being left, a fresh growth is certain to occur.
Generalisation, which may extend to all the viscera (lymphatic glands, liver, spleen, lungs, pleura, peritoneum, heart, etc.), is indicated by rapid wasting, fever, acceleration of breathing, digestive disturbance, and sometimes coughing, etc.
Local new growths assume the form of ulcerating swellings. In practice, if the general condition can be improved for a short time, it is advisable to slaughter the animal.
ACCESSORY GLANDS OF THE GENITAL APPARATUS.
(PROSTATE, VESICULAR SEMINALES, COWPER’S GLANDS.)