100 AMPUTATION OF THE PENIS 



After the penis has been drawn out, aad the preputial 

 region carefully cleansed and disinfected, an assistant grasps 

 the organ just behind the preputial ring and holds it firmly, 

 A catheter is then introduced into the urethra and pushed 

 upwards beyond the point where it is designed to amputate 

 the organ and a temporary elastic ligature, T, is then ap- 

 plied above the assistant's hand around the penis, or a piece 

 of tape is looped around it above the hand and is made to 

 serve both as a tourniquet and as a means for holding the 

 penis. Or the penis may be grasped in front of the liga- 

 ture with double tenaculum forceps and held. 



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

 41, and then make a triangular incision on the ventral sur- 

 face of the organ about 4 cm. long by 3 cm. wide, the base 

 of the triangle being forward as shown in the figure ; 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 trian- 

 gular wound, insert a series of interrupted sutures as shown 

 in Fig. 42, 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 mucous 

 membrane is brought into apposition with the integument. 

 Continue these sutures down to the base of the triangle, 

 after which remove the catherer and excise the organ by a 

 cut extending in a slightly oblique direction from below 

 upward and forward. Take a straight needle armed with 

 a silk suture and passing it through the inargin 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 cap- 



