A review of our cases of urinary obstruction due to prostatism, in which urethral catheter drainage had been used as a means of preliminary preparation for operation, revealed that the preoperative morbidity and mortality in patients who were otherwise good risks was relatively high, and that complications were not infrequent. Further study of this group showed that these undesirable occurrences were directly attributable to urinary sepsis, and that in every instance this was introduced or accentuated by some form of urethral instrumentation. For this reason we believed that a method of drainage other than the urethral catheter should be used, and therefore in the past two years we have substituted suprapubic trocar drainage for such patients. A series of thirty-two cases of patients with urinary retention due to benign hypertrophy and carcinoma of the prostate treated in this manner has been reviewed, and the results of this study analyzed. By this method of preoperative preparation, the routine care of patients with obstruction of the bladder outlet is greatly facilitated, the urinary tract infection which accompanies urethral drainage is largely eliminated, excellent decompression of the bladder can be maintained without the subjective discomfort so often attendant upon an inlying urethral catheter and complications are infrequent. As a result of our experience, we believe that suprapubic trocar drainage of the bladder is an entirely safe procedure, and that its use in acute and chronic urinary retention due to prostatic obstruction has substantially reduced the preoperative and postoperative morbidity and mortality of this disease.
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May 1, 1957
Isidore Cohn + 1
