OCR Text |
Show 94S OPERATIONS ON THE PENIS- cerous ulceration, and which is marked by the enlarged pores, and by a greasy exudation. I have not, however, seen this in cancer of the penis. Stretching the penis it may be cut 011' at once, with one stroke of a large scalpel. Two incisions, I believe, will be better; but in doing this we may recollect that we need have no precaution here of saving the skin. The length of the integu~ ments is an inconvenience afterwards. When the body of the penis is cut through, it shrinks from the assistant's grasp, and is buried among the integuments. It is now that assistance is necessary to the surgeon; for the penis retracted within the skin bleeds powerfully. The assistant must, with his fore and middle finger, push back the in~ teguments, so that the body of the penis may be made to protrude. He should at the same time grasp the body of the pe- < .- 2.53.1"! :‘v 2"" "A" ‘ nis with his fingers of the other hand, so as to do the office of OPERATIONS on THE PENIS. SJ turbed with bleeding; but it must be remembered that these arteries and their branches are enlarged in proportion to the size of the tumour and the activity of the disease ; and that, as much of the disease is in the prepuce, its arteries (from the dor- salis penis and the middle external pudic) are much enlarged, and may require ligaturesa. Should there take place, after all our care, a bleeding or oozing to any extent, we have it in our power to compress the penis with a bandage, introducing previously a female catheter 01' silver tube into the urethra. But as the stump contracts very much, I fancy this w ill sometimes not be very easy. I have never seen it necessary. The skin is brought together by a single strap across ; dry lint is put above this, and a broad band made to come up from betwixt the legs. The only care should be to keep the urethra free below. To do this no contrivanee of bougies will be a tourniquet. necessary, I believe; but if the integuments are hanging long As the time elapses during the operation, the skin becomes more troublesome, and though it appeared that you began your operation within an inch and a half of the glans, the pe over the stump, as they have no glandular apparatus for defending them from the mine, they may become very troublesome, from swelling and excoriation. We may be under the necessity of using the bougie, after nis will soon have shrunk as it were into the perineum. the healing of the parts, from the contraction of the extremity of the urethra. * The practice recommended, of disregarding the bleeding from the arteries ofthe penis, must have arisen from looking upon these Vessels in the natural state ofthe parts, not surely from experience in practice. The chief vessels to be taken up, are, 1. The dorsal arteries . 2. The next are those two which run near the septum in the spongy body. If these four vessels, branches of the internal pudie, are tied, the patient will not probably be further dis |