In the suppurative variety of prostatitis extreme dilatation of the ducts and racemose glands of the prostate may exist, constituting an advanced stage of the parenchymatous form of inflammation. The pseudo-cysts are distended with the products of suppurative inflam mation—i.c.. muco-pus, and epithelial debris, in conjunction with the prostatic secretion proper. The prostatic tissue may be relatively atrophied by pressure malnutrition, while an actual increase of bulk from the neoplastic formation exists. The cavities formed by occlu sion of the prostatic ducts and glands and the accumulation of patho logical products within them may open into the substance of the glands, producing infection and extensive abscess formation. True abscesses usually exist in several forms, viz. : a. There may be one large abscess circumscribed from the beginning or formed by fusion of several smaller pus cavities; b. Disseminated small foci of sup puration may exist; c. The peri-prostatic tissue may be the seat of the abscess. In such cases a peripheral prostatic abscess has in all probability ruptured into the peri-prostatic tissue and produced sec ondary infection in this locality. Thompson has encountered cases in which several, abscesses from the size of a grain of sago to that of a large pea were found in the substance of the gland. The prostatic utricle is sometimes dilated and filled with pus. Large or small abscesses often communicate with the urethra, in which event they are likely to contain the products of urinary decomposition. The abscess cavity may communicate with the rectum, perineum, blad der, or urethra. Abscesses may be found where no symptoms of prostatic suppuration existed during life. Civiale relates the case of
an old man who was under careful observation in the Hoptial Necker for twenty days. There was no suspicion of prostatic abscess, yet among the many serious lesions of the genito-urinary tract which were found upon autopsy was a large abscess of the left lobe of the prostate. Abscesses of this character may be found in almost any chronic disease of the genito-urinary tract, stricture of the urethra being perhaps most frequently followed by such abscesses. Suppu ration may occur as a result of infection from cystitis or prostatic hypertrophy, or vesical calculus. When suppuration has occurred in the course of prostatic hypertrophy or of the treatment for that con dition, the prostate presents the ordinary characters of hypertrophy associated with suppuration. In some instances the prostate atro phies completely under the pressure of the pus. The capsule of the prostate and the peri-prostatic tissues under such circumstances un dergo fibroid transformation and form a pseudo-cyst containing pus and communicating perhaps with the prostatic urethra. Tubercular deposits may be found in connection with chronic inflammation of the prostate, this condition being classified by some authors as tubercu lous prostatitis. The abscess under such circumstances may be due to one or both of two conditions, namely, to caseation of tubercular tissue or to pus infection. Tubercular prostatitis merits fuller con sideration, which will be given it under the head of prostatic tuber culosis. It is possible that in some cases chronic prostatic abscess , is clue to suppurative adenitis from mixed infection.