Rectal lymphogranuloma venereum in Jamaica

The clinical features of rectal lymphogranuloma venereum are described. The 91 cases of rectal lymphogranuloma have been studied at the University College Hospital of the West Indies since 1953. The pathogenisis of the disease is discussed and some doubts are expressed about the commonly accepted theory. The Complement Fixation Test appears to be no guide to the efficacy of treatment. The antibiotics are effective in producing a clinical cure of the disease in over 70 percent of cases, and have a beneficial effect even on the cases of established stricture. Radical surgery is used in cases of severe stricturing,"Esthiomene" or with recto-vaginal fistulae. Other forms of treatment have been used, being ineffective and occasionally dangerous

Retention of urine due to prostatic obstruction

In conclusion then, we can summarize our views on the treatment of retention of urine due to enlarged prostate: (1) There are very few indications for two stage prostatectomy whether for acute or acute-on-chronic retention. (2) Some form of one stage operation is desirable. Immediate operation without any preliminary drainage can be performed in a few selected cases. (3) The vast majority of prostatic patients whom we see here, need investigation and treatment not only for their urological troubles, but for many associated diseases. Very few are in a fit state to undergo major surgery without some preliminary build up, both mental and physical. Preliminary drainage by urethrostomy followed by a retropubic prostatectomy is an extremely satisfactory routine. A stage has been reached in prostatic surgery where we can say with Terence Millin (1947) whom I now quote: 'We can at least offer the prostatic patient a relatively simple relief from his urinary trouble, not in a few clinics staffed by outstanding men, but in a large number of urological services throughout the country. We have now a remarkably safe operation with easy convalescence giving permanent relief with a quick return to normal activities' (AU)