The purpose in presenting this subject is twofold: first, to present additional evidence on perineal prostatectomy as to its relative safety and good end results and, secondly, to endeavor to stimulate wider interest in the perineal surgical treatment of carcinoma of the prostate.
There are four available methods of relieving prostatic obstruction surgically: suprapubic, retropubic, transurethral resection and perineal prostatectomy. Each of these methods has certain advantages and disadvantages.
The suprapubic route is probably the easiest surgical method to master, requiring the shortest period of training to perform successfully, and uniformly gives good end results. Against it is the somewhat higher mortality than that of any other method, averaging in competent hands 4 to 6 per cent. Morbidity also is greater and hospital time longer. It should not be attempted in the treatment of fibrotic or calcareous obstructions or suspected cancer. In my own practice the procedure is limited to