Identifier: annalsofsurgery22philuoft (find matches)
Title: Annals of surgery
Year: 1885 (1880s)
Authors:
Subjects: Surgery
Publisher: Philadelphia Lippincott
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: University of Toronto

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. This flap is />, i), in Fig. 2. Theurethra is held up out of the way while the cavernous bodies areseparated either by light touches of the knife or by blunt dissec-tion ; in fact, they can be pushed apart with the end of the finger(see Fig. 2, 6^). A slight incision is necessary in the glans. The urethral flap is then laid in the gutter thus formed, andheld in position byJ;wo sutures through mucous membrane andskin tied on under surface of penis (see Fig. 3, A). A silver catheter is then laid in the urethra and a canal is OPERATIVE TREATMENT OE EPISPADIAS, 691 formed by continuous suture of the free edges of the mucousmembrane. Above this the corpora cavernosa are broughttogether, and retained by a continuous suture. The skin isusually so abundant that it can be brought together above this.Then a few well applied deep sutures are put into the skin andfat of the mons veneris, leaving a penis that looks normal savefor a straight line of sutures along the dorsum (see Fig. 4). -5-7.
Text Appearing After Image:
EXPLANATION OF DIAGRAMS. Fig. I.—The dorsum of the penis in a complete epispadias. A,The dotted line represents the line of incision for urethral flap. B, Theinfundibulum or opening into the bladder. Fig. 2.—A transverse section of an epispadias. A, A, The corporacavernosa. B, B, A transverse section of flap composed of urethra, and,if necessary, the remains of the corpus spongiosum. C, The line ofincision between the corpora cavernosa down to the skin on the undersurface of penis. Fig. 3.—A transverse section of an epispadias showing the cavern-ous bodies separated. The urethral flap (B, B) laid in the gutter anda retention suture (A) in place. Fig. 4.—Transverse secticn of penis after operation showing thesutures (A, A, A, A) in place. There are several questions that present themselves in thisoperation. The patient should be at least ten years of age, for at thattime the penis has developed so much as to make manipulation 692 /: V. CANT WELL. easy and the cavernous bodies a

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