c c, are seen
enlarged, and from the inner side and base of each, irregularly shaped
masses, a, b, d, project, and bend the prostatic urethra first to the
right side, then to the left. The part, a, resting upon the part, b,
acts like a valve against the vesical outlet, which would become closed
the tighter according to the degree of superincumbent pressure. A
flexible catheter would, in such a case as this, be more likely,
perhaps, to follow the sinuous course of the prostatic passage than a
rigid instrument of metal.

[Illustration]
Plate 61.--Figure 6.

Fig. 7, Plate 61.--A globular mass, a, of large size, occupies the neck
of the bladder, and gives the vesical orifice, c, a crescentic shape,
convex towards the right side. The two lobes of the prostate, b, are
much enlarged.

[Illustration]
Plate 61.--Figure 7.

Fig. 8, Plate 61.--The lateral lobes, b b, of the prostate are
irregularly enlarged, and the urinary passage is bent towards the right
side, c, from the membranous portion, which is central. Surmounting the
vesical orifice, c, is seen the tuberculated mass, a, which being
moveable, can be forced against the vesical orifice and thus produce
complete retention of urine. In this case, also, a flexible catheter
would be more suitable than a metallic one.

[Illustration]
Plate 61.--Figure 8.

Fig. 9, Plate 61.--The lateral lobes, b b, of the prostate are enlarged.
The third lobe, a, projects at the neck of the bladder, distorting the
vesical outlet. A small calculus occupies the prostatic urethra, and
being closely impacted in this part of the canal, would arrest the
progress of a catheter, and probably lead to the supposition that the
instrument grated against a stone in the interior of the bladder, in
which case it would be inferred that since the urine did not flow
through the catheter no retention existed.

[Illustration]
Plate 61.--Figure 9, 10.

Fig. 10, Plate 61.--Both lateral lobes, b c, of the prostate appear much
increased in size. A large irregular shaped mass, a, grows from the base
of the right lobe, and distorts the prostatic canal and vesical orifice.
When the lobes of the prostate increase in size in this direction, the
prostatic canal becomes much more elongated than natural, and hence the
instrument which is to be passed for relieving the existing retention of
urine should have a wide and long curve to correspond with the form of
this part of the urethra. [Footnote]

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