Identifier: surgeryitsprinci04keen (find matches)
Title: Surgery, its principles and practice
Year: 1906 (1900s)
Authors: Keen, William W. (William Williams), b. 1837 Da Costa, J. Chalmers (John Chalmers), 1863-1933, joint ed
Subjects: Surgery General Surgery
Publisher: Philadelphia and London : W. B. Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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obtained in a normal prostatic orifice areshown in Fig. 218. As remarked above, these are considerably magnified,and inverted, so that in order to get a correct idea of the orifice eachfigure will have to be inverted. The shape of the prostatic orifice depends upon the pressure which isbrought to bear upon it by single or multiple enlargements of the variousportions of the prostate. These are generally outgrowths of one orboth of the lateral lobes or of the median lobe. Only rarely does onefind enlargement of the anterior commissure of the prostate. The changeswhich occur may be shown diagrammatically, as in Fig. 219: a representsthe normal prostatic orifice; h, the orifice compressed between two en-larged lateral lobes; c, a median lobe pushing the urethra upw^ard; d, asingle anterior lobe (rare); e, hypertrophy of the median and both laterallobes; /, hypertrophy of an anterior and both lateral lobes; g, enlarge-ment of four portions of the prostate, anterior lobe, two lateral lobes,
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Fig. 217. -Position of Cystoscope when Viewin© Margin ofProstatic Orifice. 422 SURGERY OF THE PROSTATE. and a median lobe; h, the median and right lateral lobes confluent, thatis, forming a single large mass (two sulci being present, one betweenthe two lateral lobes and one between the left lateral and median lobe);

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