Identifier: plasticsurgeryit00davi (find matches)
Title: Plastic surgery; its principles and practice
Year: 1919 (1910s)
Authors: Davis, John Staige, 1866-1933
Subjects: Surgery, Plastic
Publisher: Philadelphia, P. Blakiston's son & co
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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l hypospadias. Patient 24 years old. No. 5559.—The urethralopening is about on the level with the cross mark. The testicles are apparently normal.The scrotum is bifid and the penis which is markedly curved forward, is considerably smallerthan normal. tion on the penile portion of the urethra, which is the only part of theoperation in which the result is at all precarious. The perineal por-tion, where the surface is broad, scarcely needs any suturing; the suturesthere will, of course, just miss the mucous membrane. Fig. 296,2 shows the operation completed. The objection to this operation is that hair will probably grow onthe scrotal skin which is used to form the lower half of the urethra. HYPOSPADIAS 333 METHOD OF CHOICE I prefer Russells method of forming the glandular urethra, andhave done a number of cases in this way without a single failure. Itis somewhat difhcult to understand the application of the flaps, butonce understood, it is in my opinion the best method as yet devised.
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Fig. 298.—Perineal hypospadias, conlinued.—The result of several operations. Thepenis was straightened and the urethra in the glans was made by Russells method. Thepenile and perineal urethra was formed by a modified Duplay operation, and then thenewly formed sections of the urethra were joined. Several months were allowed to elapsebetween each operation. The photograph shows the operation completed, and with a No.26 sound (French) passing through the newly formed urethra into the bladder. The formation of the flaps in this way is very satisfactory, and canbe used in the complete penile as readily as in the perineal type. Isometimes use the Duplay method for forming the penile urethra. Xosatisfactory way has been devised to avoid the use of scrotal skin informing the perineal urethra below the penoscrotal junction, and asthe growth of hair is the main objection to its use I would suggest thatthe hair follicles be destroyed with radium or .v-rays (after carefullyprotecting the test

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