DISEASES OF PROSTATE GLAND The prostate gland may become acutely inflamed as the result of the backward extension of gonorrhoeal inflammation of the urethra; it may also be attacked by the germs of ordinary sup puration or by B. tuberculosis. As a result micturition and de faecation are difficult, painful or impossible. If abscess forms, it should be incised from the perineum; if allowed to run its course it may burst into the bladder, urethra or rectum, and set up serious complication. Chronic prostatitis is a legacy from gon orrhoea. The enlargement gives a feeling of weight and fullness in the perineum, irritability of the bladder, and a urethral discharge.
Enlargement of the prostate exists in a considerable proportion of men of about 6o years of age and onward. It consists in forma tion of an adenoma in the gland or overgrowth of the normal muscular, glandular or fibrous tissue. In either case the passage of urine is impeded, hypertrophy and dilatation of bladder super vene and the organ cannot be emptied completely. If putrefactive organisms gain access to this stagnant urine, cystitis and perhaps renal disease and stone may follow. The seriousness of enlarge ment of the prostate depends mainly upon the inability of the patient to empty his bladder completely. Surgical removal of the enlarged mass is successful in many cases.
Malignant disease of the prostate is distinguished from senile enlargement by the rapidity of its growth, by the freeness of the bleeding which is associated with the introduction of a catheter, and by the marked wasting which the individual undergoes. Un fortunately, by the time that the cancerous nature of the disease is definitely recognized, the prospect of relief being afforded by operation is small. Some success has followed radium treatment.