Is assessing the prognosis and results of prostatectoniy lor enlarged prostate, attention has hitherto been confined mainly to two considerations, the per-5onal factor of the patient and the type of operation performed. As regards tlie patient, tlie duration of symptoms arid consequent degree of renal inipairnient appear t o he of niore importance than his actual age, and the presence of extra-iirinar! disturbances undoubtedly affects the final results in a series of cases. A5 rcgards the type of operation, discussion still continues on tlie relative merits of suprapubic., perineal. arid perurctlir:~l prosttatechtom? , and of the open or closed operation in the first procedure. Man?-\ariations in after-trcatmcnt itre also in use, and for each sonic benefit is claimed in rediieing complication5 and improving results generally. One factor in prognosis T.\ hich appcar5 to hare recei\ ed insuff icicnt consideration is the histology of the prostate renioved. Cases of frank carcinoma, or those which prore to be malignant on niicroscopical exmiination. are notoriously difficult to remove arid prone to recur : but even if these are excluded it is found that some prostates are enticleated casily and others with difficulty. so as t o necessitate dissection. and therc 15 a general impression that tlie former are niorc satisfactory in their encl-result5 than the 1attcr.l Tlic present investigation has been imdcrtakcn in order to establish, if possiHc. stiitistical evidence of w correlation betwccn tlic type of prostate. the $1 niptonis produced. and the incidence of c*omplicatioiis and ultiinate prognosis after prostatectoniy. For this piirposc all cases of prostatevtomy a t the Jliddlesc\-Hospital from 1024 t o 1031 ha\ e hcen rcriewetl. They number 114. escluding those of nialignant disease of the pro\tate, and incluclc the results of nine different surgeons. , 411 the c.sscs \$ere submitted to suprapthi(* prostatectoniy. and this is the one common factor ; the majority were carried out h\ E'reycr's technique. but in some the open operation of Thonison-Walker \\as performed : ligature of the vas was added in a few ( x s c s . The after-treatment given differed according to the practicc of the indir idual wrgcon. Despite thew x ariations. the relative inc+leiice of inf1ammator~-coinplications was about the sanic ~ ~--~~ -* From the Ikpartment of I rology .inti the 13lantl-S,rttton Institute of P~t l l o l o p~, \Iiddlesex Hospital. and the Ro? :XI College of Surc(eons
