THE PROSTATE GLAND. 



1975 



furrow between the two cavernous bodies. Phlebitis occasions much more marked 

 oedema. 



Epithelioma of the penis is not uncommon. It usually follows prolonged subpre- 

 putial irritation. It involves ultimately both the inguinal and the deep pelvic nodes. 



Amputation of the entire penis may be required for the relief of malignant dis- 

 ease. The following description (Treves) should be studied in connection with the 

 anatomy of the penis and of the urethra. The patient is placed in the lithotomy posi- 

 tion, and the skin of the scrotum is incised along the whole length of the raphe. With 

 the finger and the handle of the scalpel the hah-es of the scrotum are separated down 

 to the corpus spongiosum. A full-sized metal catheter is passed as far as the trian- 

 gular ligament, and a knife is inserted trans\'ersely between the corpora cavernosa and 

 the corpus spongiosum. The catheter is withdrawn, the urethra is cut across, and 

 its deep end is detached from the penis back to the triangular ligament. An incision 

 is made around the root of the penis continuous with that in the median line. The 

 suspensory ligament is divided and the penis is separated, except at the attachment 

 to the crus. The knife is then laid aside, and with a stout periosteal elevator or rugine 

 each crus is detached from the pubic arch. The two arteries of the corpora cavernosa 

 and the two dorsal arteries require ligature. The urethra and corpus spongiosum are 

 split up for about half an inch, and the edges of the cut are stitched to the back part 

 of the incision in the scrotum. The scrotal incision is closed by sutures, and if drain- 

 age is used, the tube is so placed in the deep part of the wound that its end can be 

 brought out in front and behind. No catheter is retained in the urethra. 



THE PROSTATE GLAND. 



Although developed as an appendage of the urinary tract, and not directly as 

 part of the sexual apparatus, the prostate is functionally so closely related to the gen- 

 erative organs that it may appropriately be regarded as one of the accessory glands, the 

 others being the glands of Cowper. 



The prostate is complex in both its make-up and relations, being partly glandu- 

 lar and partly muscular and traversed by the urethra and the ejaculatory ducts. In 

 general form it resembles an inverted 



Spanish chestnut, having the base Fig. 1679. 



applied to the under surface of the 

 bladder and the small end, or apex, 

 directed downward. Additional an- 

 terior, lateral, and posterior surfaces 

 are recognized. Grayish red in 

 color and of firm consistence, the 

 adult prostate varies considerably 

 within physiological limits in size 

 and weight. The former includes a 

 length, from apex to base, of from 

 2. 5-3. 5 cm. ( I to I ^ in. ) , a breadth 

 or transverse diameter of from 3. 5- 

 4.5 cm. (i3/i—i}i in.), and a thick- 

 ness of from 2-2.5 cm. (|--i in.). 

 Its average weight is about 22 gm. 

 (i^ oz. ). Marked increase in size 

 and weight is common in elderly 

 subjects. 



The oblique upper surface or 

 base (basis prostatae, facies vesicalis) is applied to the under surface of the bladder, 

 with which it is inseparably blended by muscular tissue surrounding the urethral ori- 

 fice, and is pierced by the urethra usually slightly in advance of the middle. The 

 base is outlined by free rounded borders, so that its limits are separated from the 

 vesical wall by a groove. T\\e posterior siirface (facies posterior), directed backward 

 and towards the rectum, is defined laterally by prominent rounded borders that 

 extend from the base to the apex and enclose a flattened cordiform or triangular area 



Slight groove produced 

 by symphysis 



Inferior surface 



Cut urethra 

 in apex of 



prostate 

 \'as 

 deferens 



surface 



^Ureter 



Seminal 

 vesicle 



Slightly distended bladder, hardened in situ, show- 

 ing prostate, seminal vesicles, and seminal ducts ; viewed 

 from below and behind. 



