chap.xvin.j THE PROSTATE 401 



The prostatic abscess usually bursts into the 

 urethra, that being the direction in which least 

 resistance is encountered. If it does not enter the 

 urethra, it will probably open into the rectum, there 

 being only one layer of the pelvic fascia, and that 

 layer not a thick one, between the two organs. 

 Indeed, the posterior part of the prostatic capsule, 

 and the anterior part of the sheath of the rectum, 

 are continuous. Failing these two points of exit, 

 the abscess may progress towards the perineum. 

 This course, however, is not very usual, the advance 

 of the abscess being resisted by the dense posterior 

 layer of the triangular ligament, with the lower edge 

 of which the prostatic capsule is continuous. If the 

 abscess reaches the perineum, it will do so by running 

 along the side of the rectum. The abscess cannot 

 make its way into the pelvic cavity, its movement in 

 that direction being resisted by the pubo-prostatic 

 ligaments which form one of the very densest portions 

 of the pelvic fascia. This encasement of the gland 

 in an unyielding membrane will serve to in part 

 explain the severe pain felt in acute prostatic abscess. 



Hypertrophy of the prostate. The average 

 measurements of the normal prostate are an inch 

 and a half across at its widest part, and an inch and 

 a quarter from before backwards, or from apex to 

 base. After the age of fifty-three the organ is very 

 apt to become hypertrophied ; arid, according to Sir 

 Henry Thompson, this hypertrophy may be considered 

 to exist when the gland measures two inches from 

 side to side, or when it weighs one ounce. The usual 

 weight of the prostate is six drachms. If the 

 enlargement mainly affect the lateral lobes, it will 

 be understood that the hypertrophy may attain 

 considerable dimensions without retention of urine 

 being produced. On the other hand, a comparatively 

 trifling enlargement of the middle lobe may almost 

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