270 DISEASES OF THE PENIS AND PREPUCE 



swelling and a reddish colored discharge from the prepuce. 

 Micturition is frequent, and the penis is protruded from the 

 prepuce. On palpation the prepuce will be found swollen 

 and irregular in outline. On exposing the penis, it will be 

 tumified, purplish or dark red in color, and on its surface 

 presents a number of vegetative growths. These growths 

 may be found also on the prepuce. They are characterized 

 by their soft friable condition, tendency to bleed at the least 

 touch; they may be sessile or pedunculated. The growths 

 first appear in the form of small vesicles, which soon develop 

 into pimples at first of a firm consistency, but as they grow 

 become softer and more friable. Their growth is slow. In 

 six months to one year they can involve most of the prepuce 

 and penis. Examination of the inguinal lymph glands often 

 reveals enlargement and secondary changes. 



Diagnosis. This must be based mainly on the infectious 

 character of the growth (its spread by coition), and its char- 

 acteristic development. 



Prognosis. The tendency to reappear after removal and 

 the spread to other animals make the prognosis unfavorable. 

 Often when the growths are removed from one area they 

 reappear on another. 



Treatment. Complete removal of the growths surgically 

 is recommended when possible. On account of the tendency 

 to recur, they should be completely dissected out, even includ- 

 ing some of the normal mucosa. It is advisable to cauterize 

 the surface after their removal, and to treat the wounds with 

 antiseptics. In all cases the patient must be closely observed 

 and at the first sign of recurrence of the growths, promptly 

 operated. In advanced cases, with extensive involvement 

 of both the penis and prepuce, and where general symptoms 

 of emaciation and weakness are present, the penis should 

 be amputated even including a portion of the prepuce. 



