JAMA. 1917;LXVIII(6):444-452. doi:10.1001/jama.1917.04270020124012.
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The subject of obstructions at the vesical orifice with attendant distressing symptoms has occupied the attention of surgeons for many generations. Interest in this particular field of urology has been much stimulated recently by the fact that cystoscopic examinations have become a routine procedure in cases of patients who are suffering from urinary disturbances.

In urology as in other fields of medical science the progressive surgeon is alert to discover early pathologic conditions in order that relief may be prompt and effective, thereby eliminating much suffering and repairing damaging conditions.

In this discussion it seems advisable to consider vesical orifice obstructions other than those caused by enlargement of the prostate gland proper which is believed to be a subject apart.

The older writers recognized several types of vesical orifice obstructions. Sir E. Home1 described what we now know to be hypertrophy of the subcervical group of Albarran as the


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