1920 Archives of Surgery  
During the last two years we have made a study of the blood pressure changes which occurred during the hospital management of patients suffering from prostatic obstruction. The original object of these observations was to obtain, if possible, additional data which might assist us in determining the most advantageous method of preparing such patients for operation as well as the most suitable time for undertaking such an operation. Also, observations on the blood pressure of patients who have
more » ... atients who have been relieved of their urinary obstruction for some time have revealed findings worthy of note. This report comprises the results of the study of fifty-six patients with urinary retention due to prostatic obstruction, fifty-five of whom were operated on. The average age of this group was 61 years. The oldest patient was 86 and the youngest 46 years of age. Prior to the estimation of the amount of residual urine, the blood pressure reading was recorded. A blood pressure reading was made every twenty-four hours for four days, and then every second day during the patient's stay in the hospital. Whenever possible the same house officer made all the readings throughout the entire hospital management of the individual case. He used the same standard type of mercury manometer to record all of the readings. EFFECT OF DRAINAGE OF THE BLADDER Sudden Fall in Blood Pressure.-When the bladder is kept at com¬ plete rest by an indwelling catheter, or by suprapubic cystotomy, a very appreciable fall in blood pressure occurs during the first twentyfour hours. In this series, the average fall in systolic blood pressure was 40 mm. of mercury at the end of this time. The average fall in diastolic blood pressure was 14 mm. of mercury. The most marked diminution occurred in those patients who pre¬ sented themselves with a marked hypertension, in nearly every in¬ stance associated with a considerable amount of residual urine (400 or more cubic centimeters). To a great extent the degree of fall seemed to depend almost entirely on two things : the quantity of residual urine; and the degree of reduction of renal function. The presence or absence of infection of the urinary tract made no obvious Downloaded From: http://archsurg.jamanetwork.com/ by a University of Iowa User on 06/09/2015
doi:10.1001/archsurg.1920.01110020154005 fatcat:4g2jcdlhtvafbi4c7e2ivumutm