File:Operative surgery (1899) (14777954384).jpg

Identifier: operativesurgery02brya (find matches)
Title: Operative surgery
Year: 1899 (1890s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914
Subjects: Surgery, Operative Surgery, Operative
Publisher: New York : D. Appleton and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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of an inch, and broughtthe free end of the urethra out of a wound made in the perinaeum an inchand a half in front of the anus, to the borders of which the extremity of theurethra was stitched. Dnvies-Colly amputated the penis at the scrotum; then, through an inci-sion made into the posterior scrotal rhaphe down upon the urethra, he iso-lated the corpus spongiosum, brought the divided extremity out through theopening, and stitched its borders to those of the incision. The Precautions.—If the amputation is to be made close to the sym-physis, retraction of the stump and infiltration of the scrotum with urinemust be guarded against. If a stout ligature be passed through the fibroussheath of the penis, a little above the point of proposed section, the stump canbe controlled and the first accident, and possibly the second, will be obviatedby this means. At all events, the infiltration can be prevented by dividingpartly or entirely through the scrotum and the floor of the urethra, in the
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Fig. 1449.—Amputation of penis by transverse division, a. Act of amputating organconstricted with rubber tube. h. End of stump, showing vessels, urethra, and cavern-ous bodies, c. Integument united to urethra. line of the urinary canal, and uniting the borders of the integument to thoseof the urethra so as to form two scrotums (Fig. 1450 ), with the urinaryopening between them. A disarrangement of the drainage or withdrawal ofthe catheter by traction on the tube often leads to prompt saturation ofthe dressings. If the patient be intractable in this respect, the catheter isemployed every four or five hours, and it may be withdrawn entirely or onlypartially after each introduction, as may be deemed essential. If completewithdrawal be practiced, a long silkworm-gut suture should be stitched at the OPERATIONS ON THE SCKOTLM AND IKNIS. 122; N %

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