Of 34 cases of prostatic hypertrophy where the rasa deferentia were excised; 4 died of other diseases; in 2 cases the results were negative; the remaining 28 were either cured or improved. When good results do not follow this operation it is because complete obliteration of the vas deferens has not been obtained. Therefore, in addition to excision, the ends of the canal should be twisted, so as to insure complete closure. Pavone (II Policl., No. 15, '96).
In 10 cases of hypertrophy of the pros tate in which the following method of op eration was used, a satisfactory result was noted at the end of two months. Only 2 of the patients were put under chloroform. The vas deferens is pinched up with the left hand and the skin incised for an inch; with a blunt instrument the canal is isolated, drawn out the length of six or eight inches, torn off the epi didymis, and excised. The wound, treated antiseptically, is closed and covered with collodion. A suspensory bandage is ap plied, and the patient returns to his oc cupation. Although resection of the vas deferens does not equal double castration in efficacy. it frequently succeeds in im proving sufficiently the condition of the patient. Helferich (Med. Press and Circ., Feb. 26, '96).
Resection of the vasa deferentia is par ticularly indicated in the middle period of prostatism when the patient's troubles —cystitis, hcematuria, and complete or incomplete retention—are usually the re sult of congestion. In a later stage, in
which the enlargement and deformity of the prostate are due to well-developed structural changes, resection of the vasa deferentia, though it may render service by relieving pain, will necessarily fail to do much good. Nova-Toperand (Lyon nad., Oct., '96).
Vasectomy is of no service in cases of prostatic enlargement characterized rather by intravesical projection than by general increase in bulk. When this con dition is present and the obstruction is due to a small nodule, the Bottini opera tion is especially applicable. Nicolieh (La France Med., Dec. 23, '93).
Vasectomy is specially effectual in the early stages of prosta tie hypertrophy. When the prostate has assumed the form and structure of a fibrous growth, some other form of prostatectomy is preferable to either vasectomy or castration. When secondary changes have taken place in the bladder itself, in the form of sacs or trabeculre, the possibility of restoring its natural functions by any means is ex tremely unlikely. Reginald Harrison (Lancet, May 5, 1900).