368 



The dissection of the skin and subjacent cellular and adipose tis- 

 sues is to be made towards the penis, on the level of the fascia lata 

 laterally, and of the perineal fascia posteriorly, and carefully con- 

 tinued to the body of the penis, as far as the corona glandis. By 

 this means, the penis, as -well as the suspensory ligament, is denuded 

 of its loose movable investments. 



An incision is then to be made along the dorsum of the penis, 

 exactly in the median line, splitting through the suspensory ligament, 

 and extending forward to the corona, between the dorsal vessels and 

 nerves that run parallel on either side. The adhesions of the sheath 

 along the dorsum arc firm, and require careful dissection; the blood- 

 vessels and nerves being raised with it, serve as a guide to show the 

 line of adhesion. 



The dissection being prosecuted laterally as well as inferiorly and 

 at the extremity, the entire corpus cavernosum is enucleated, the 

 muscles of the perineum being raised with the sheath. It is now 

 clearly seen that the suspensory ligament from above, and the pe- 

 rineal fascia from below and laterally, form one continuous mem- 

 brane with the sheath, inclosing the corpus cavernosum in its cavity, 

 and embracing the corpus spongiosum urethras between two layers, 

 one of which passes above, and the other below it. The excavated 

 base of the glans adheres inseparably to the outer surface of the 

 sheath, while, by means of its inner surface, it caps the summit of 

 the corpus cavernosum. 



Its adhesions are most firm at the extremity of the corpus cavern- 

 osum, along its dorsal surface, and at the insertions of the erector 

 and accelerator muscles. 



It is thickest around the corona, along the dorsal surface, and 

 where it forms the suspensory ligament. 



Zones of vessels run at regular intervals in the direction of the 

 circumference of the penis, from the dorsal trunks to the corpus 

 spongiosum, between the layers of the sheath. 



The cavity formed by the sheath, and occupied by the corpus ca- 

 vernosum, is limited posteriorly by the triangular ligament. 



That portion which covers the perineal muscles, and has been de- 

 scribed by authors under the names of the superficial fascia of the 

 perineum, inferior fascia and ano penic fascia, arises laterally from 

 the ascending rami of the ischium, and descending of the pubes, as 

 far forward as the inferior edge of the symphysis, where the two 

 layers meet and form the suspensory ligament. Posteriorly, it is 



