400 
AMPUTATION OF THE PENIS. 
first ligature the dorsal vessels, others cut through them at once; 
Barthelemy and Chariot operated in this way in the horse, Fellenberg in 
the dog. Two ligatures are applied, between which the amputation is 
made ; the upper ligature prevents bleeding. That even this is not 
always necessary is shown by a case of Hunting’s, where a pony’s penis 
was simply cut through, the stump compressed by an assistant for half 
an hour, and no particular bleeding ensued. If the horse is cast for 
operation, that portion of the prepuce covering the penis may be drawn 
together with sutures in front of the stump. Haase operated in this way, 
using catgut, and states having had healing by primary intention. In 
such cases it is necessary to expose the urethra, and divide its mucous 
membrane, which is stitched to the tissues on either side to prevent 
stenosis. 
If the animal is cast, the actual cautery may be employed after 
section to check bleeding. It is better to ligature each bleeding vessel 
separately, and in the horse to draw the prepuce over the stump and 
suture it in that position. 
(4) The ecraseur. This method and removal by galvano-cautery or 
ligature are the most painful, but the operation only lasts a short time, 
and an anaesthetic can be given. 
After cleansing the penis and sheath, a piece of tape is tied around 
the end of the former to furnish a good hold. The urethra is then dis¬ 
sected out for 1 to inches and cut through, after which the ecraseur 
is applied at the point to be divided and slowly turned. There is little 
resistance whilst the corpora cavernosa are being compressed and cut 
through, but towards the end of the operation it becomes greater, 
because the tunica albuginea is then undergoing division, and at this 
period the chain may occasionally be broken. In such cases one may 
pass a ligature around the remainder, and simply remove the end of the 
penis with a knife; experience has shown the operation to be perfectly 
successful, and healing has occurred rapidly and uninterruptedly. 
Moller always operates in this way. Not only is injury to the instru¬ 
ment avoided, but bleeding is very slight and the wound heals rapidly. 
The urethra may be sutured to the tunica albuginea, and if sterilised 
catgut or silk be used its edges soon become adherent, and the danger of 
stricture is reduced to a minimum. 
Nevertheless, whatever method be employed, strictures form the most 
frequent and most troublesome sequelae of amputation of the penis. 
The insertion of a metal tube in the urethra during the first week or 
two certainly obviates difficulty in urination consequent on inflammatory 
swelling, but later it operates in exactly the opposite way, and it is, 
theiefoie, bettei to avoid such tubes. Stricture may even lead to rupture 
of the bladder, as Cagny has shown. 
