Complete Closure of the Bladder Following Prostatectomy

A surgical operation in which drainage must be instituted is never an ideal operation. The necessity for drainage indicates either that some adverse condition is present, such as a pus-forming focus, as in suppurative appendicitis with peritonitis, or the danger of bile leakage after a cholecystectomy; or that the technic of the operation itself is such that danger of hemorrhage or oozing makes complete closure impracticable. It is this last possibility which has been the principal reason for the suprapubic drainage of the bladder after a prostatectomy, although the presence of a severe cystitis also contraindicates closure in some cases. For many years I have always closed the bladder after the removal of bladder stones or bladder tumors, and have maintained bladder drainage by means of an inlying urethral catheter; but until recently I have always employed a suprapubic drain after prostatectomy, partly because that is the general practice and