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Reagan Reported ‘Fine’ After Prostate Surgery : Initial Tests Show No Sign of Cancer; President ‘Working, Reading’ in Hospital, First Lady Says

Times Staff Writers

President Reagan underwent routine surgery Monday on his enlarged prostate gland, and doctors reported that initial studies of the removed tissue, as well as detailed examination of colonic polyps removed Sunday, showed no sign of cancer, the White House said.

“The obstructing portion of the prostate was removed; no complications were encountered. The President’s general condition is excellent,” White House spokesman Larry Speakes said.

The doctors removed 23 1/2 grams--slightly less than 1 ounce--of prostate tissue, the White House said.

One-Hour Operation

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“The procedure went very smoothly. There was nothing out of the ordinary,” said Army Col. John C. Hutton, the White House physician, who described the approximately one-hour operation as “very routine.”

Reagan, who entered the Bethesda Naval Medical Center in Maryland Sunday, was expected to spend three to four days recuperating in his hospital suite before returning to the White House on a limited work schedule next week.

First Lady Nancy Reagan spent Sunday evening and Monday at the hospital. On departing for the White House on Monday evening, she said that her husband was feeling “fine, thank you,” and was in bed “working and reading.”

The President met with White House Chief of Staff Donald T. Regan for about 10 minutes before the surgery, Speakes said, and the chief of staff remained at the hospital until the surgery was completed.

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Frank C. Carlucci, whom Reagan had welcomed to the White House Saturday as his new assistant for national security affairs, is expected to brief the President during his hospitalization.

During the surgery, which began at 8:15 a.m., a team of urologists led by Dr. David C. Utz of the Mayo Clinic in Rochester, Minn., widened Reagan’s urinary tract by removing overgrown prostate tissue that caused discomfort by obstructing the passage of urine.

A spinal anesthetic to numb the lower body was administered, and Reagan, who will turn 76 a month from today, was awake throughout the surgery.

The amount of tissue removed during the procedure is slightly more than is contained in the normally walnut-size adult prostate. The gland, present only in males, produces some of the fluid contained in semen.

In addition to performing the surgery, doctors examined the interior of the President’s bladder, using a lighted tube called a cystoscope. The examination indicated conditions in the bladder were normal, the White House said.

The operation, one of the most common surgeries for older men, is called a transurethral prostatectomy. It is performed through the urethra, the channel that connects the bladder to the outside of the body. No skin incision is necessary.

Pathology Report Due

Specimens of Reagan’s prostate were examined under the microscope for signs of cancer, a standard procedure, and a final pathology report is to be issued today.

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After surgery similar to Reagan’s, patients generally experience “some pain, but not a huge amount,” said Dr. Jean de Kernion, chairman of the department of urology at the UCLA Medical Center.

The President required no pain medicines immediately after the surgery, Speakes said. However, spinal anesthetics usually take three to four hours to wear off, after which some patients require painkillers.

Most patients experience bleeding from the urethra for several days, De Kernion said. A tube called a catheter is temporarily left in the urethra to drain the bladder and to monitor the bleeding, he said. Reagan was also given antibiotics, which are often used to lessen the chances of infection.

After operations, patients are routinely checked for fevers, which could signal infection. In addition, blood samples are obtained to determine corpuscle counts, kidney function and the concentration of sodium and other minerals in the circulatory system. If abnormalities are detected, blood transfusions or infusions of fluids may be necessary.

Gave Own Blood

In preparation for possible blood requirements, a pint of Reagan’s blood was drawn in advance, but it was not needed, the White House said.

Patients usually are able to take liquids or to resume eating later on the day of surgery and, by the next day, to begin to walk.

During his hospitalization, the President has also undergone a series of procedures and tests, primarily to check for recurrence of the colon cancer that was first detected in July, 1985. Four non-malignant polyps were removed from his colon Sunday.

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“They were examined overnight by pathologists and proved to be benign, as expected,” Speakes said.

Today, Reagan’s physicians will conduct a CT-scan, which is a computerized, three-dimensional X-ray of internal organs, to look for the possible spread of the colon cancer to the abdomen and pelvis.

11 Physicians Involved

Eleven physicians participated in the President’s medical procedures Sunday and Monday, including one urologist, two surgeons, two anesthesiologists and one pathologist from the Mayo Clinic, a urologist, anesthesiologist and pathologist from the Bethesda Naval Medical Center, a urologist in private practice in St. Paul, Minn., and Hutton, the White House physician.

Total charges for transurethral prostate surgery at the Mayo Clinic range from $5,000 to $6,000, a spokesman said. In 1985, 781 such surgeries were performed at the clinic, she added.

Speakes said that the cost of the President’s hospitalization is being met by the President’s “Blue Cross-Blue Shield policy from the California Legislature’s retirement system.”

“The President will pay any remaining cost from his own pocket,” Speakes said, adding that Reagan had chosen not to use his Medicare benefits, although he is eligible to do so.


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