SUMMARY Post‐operative fistulas between the rectum and prostatic cavity are discussed. Various serological factors are considered. A new exposure dividing the anal canal and rectum is described as an alternative to Kraske's post‐rectal approach.

SUMMARY Post‐operative fistulas between the rectum and prostatic cavity are described. Various etiological factors are considered. An operation using Kraske's post‐rectal approach is described. This operation makes the fistula most accessible.

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In the pre-antibiotic days-the diagnosis of cystitis or pyelitis, confirmed by the finding of turbid urine containing pus cells, was considered adequate. The identification of the responsible organism was seldom of practical importance in deciding the line of treatment to be followed, and therapy consisted in administering large amounts of fluids and sufficient quantities of soda bicarbonate and potassium citrate to render the urine alkaline. If these measures were not effective it was sometimes found that sudden changes in the urinary pH might be successful and mandelic acid was given for this purpose. Today, surrounded as we are by a formidable batterv of antibiotics, it is salutary to reflect that these old remedies, together with the natural resistance of the patient, were successful in eliminating the great majority of uncomplicated urinary infections and to remember that the principles they embody are still applicable whether or not an antibiotic is employed.