Extensive cancerous involvement of the prostate puts a case beyond the pale of operative surgery, except for palliative purposes, though either perineal or suprapubic drainage may be made for final and temporary relief, the case admitting of nothing else. As mentioned above many apparently ordinarily enlarged prostates prove to contain cancerous elements. It has been found that, when not too extensively involved, prostatectomy in these cases gives as good results as in the absolutely non-malignant.
Fig. 666
Siphon drainage of bladder, with Cathcart’s S-tube (its essential feature). May be applied equally well to perineal or urethral tubes, or to drainage of other cavities.
BLADDER SIPHONAGE.
A matter of great importance and comfort for the patient is an effective siphonage of the bladder after it has been opened. This has usually been accomplished by the use of a Y-shaped tube, one of the branches connecting with a suitable reservoir for water, hung above the level of the body, the other with a tube connecting with the bladder, while from the lower end another tube connects with a suitable reservoir on the floor. This is rarely effective, and can only be made so by inserting the S-shaped tube devised by Cathcart in the lower drainage tube. With this, and a suitable regulation of the flow, the water can be made to escape, drop by drop, and make an effective suction that completely fails without the use of Cathcart’s tube. The device is illustrated in [Fig. 666].
CHAPTER LVI.
THE MALE GENITAL ORGANS.
THE PENIS AND URETHRA.
The most common congenital defects of the penis are connected with elongation of the prepuce or with abnormality in the construction of the urethra. Aside from these, however, rare congenital abnormalities have been met with, as, for instance, a double or bifid penis, or its almost complete absence. The former is perhaps to be regarded as an atavistic condition, having its prototype in the kangaroo. Misplacement of the organ is usually apparent rather than real.