Excerpt from The American Journal of the Medical Sciences, 1920, Vol. 159
The mortality rate following prostatectomy is in direct ratio to three vitally important factors: (1) The recognition of absolute contra-indications to operation; (2) the recognition of relative contra-indications to operation, and (3) the knowledge of methods of treatment preliminary to operation that will remove such relative operative contra-indications and thus bring the individual within the operable class.
Characteristic illustrations of these factors are most frequently found in subnormal function of the kidneys. In one instance an impending uremia may be due solely to an antecedent nephritis of the chronic interstitial type, in which event, the cause being irremovable, there is an absolute contra-indication to operation. In another instance a minor degree of interstitial nephritis may exist, but the dangerously low renal function present is dependent upon back pressure incident to lower urinary obstruction. Under these circumstances there is a relative contra-indication to operation, because after decompression of the kidneys the renal function im proves, so that eventually the obstructing prostate can be removed successfully.
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