122 AMPUTATIOX OF THE PENIS. 



Apply a small cord just behind the glans penis, L, Fig. 

 I, P ate XIX, and then make a triangular incision on the 

 ventral surface of the organ about 4 cm. long by 3 cm. 

 wide, the base of the triangle being forward as shown in 

 Fig. I ; carry this incision through the skin, S, the corpus 

 spongiosum, CS, and along the corpus cavernosum, CC, 

 down to the urethra, U. Dissect away the tissues in the 

 triangular area without opening or wounding the urethra 

 and when this has been completed make a longitudinal 

 incision from near the apex of the triangle to its base 

 through the urethral walls to the catheter. Beginning at 

 the apex of the triangular wound insert a series of inter- 

 rupted sutures as shown in Fig. 2, Plate XIX in such a 

 manner that they pass through the urethral wall and the 

 skin so that when tied the wounded surfaces are completely 

 hidden and the urethral raucous membrane is brought into 

 apposition with the integument. Continue these sutures 

 down to the base of the triangle after which remove the 

 catheter and excise the organ by a cut extending in a slightly 

 oblique direction from below upwards and forwards. Take 

 a straight needle armed with the silk suture and passing 

 it through the margin of the urethral wound, the adjacent 

 fibrous capsule of the corpus cavernosum and across but 

 not through the erectile tissue, insert it again into the 

 superior portion of the fibrous capsule and carry it out 

 through the adjacent dorsal vessels and the skin as shown 

 in Fig. 12, and, bringing the ends of the sutures together, 

 tie in such a way that the urethral mucous membrane and 

 the margin of the skin are brought into immediate contact 

 and the blood vessels securely closed in such a manner as to 

 guard against hemorrhage. By this plan when the sutures 

 are tied, the cut borders of the fibrous envelope are brought 

 together over the erectile tissue, thus preventing hemor- 

 rhage from that tissue also. Insert as many sutures as 

 may be required to completely and securely close the wound 



