402 
AMPUTATION OF THE PENIS. 
Having introduced a catheter into the urethra for a distance of 10 
to 12 inches, an assistant covers the free portion of the penis with 
a cloth, and draws it gently forwards. Another assistant, placed behind 
the patient, draws the skin covering the base of the penis towards the 
perineum. A ligature is then applied to the base of the penis. 
A little above the point where amputation is to be performed two lines, 
starting from above the urethra and diverging towards their free ends 
(an inveited V hi tact), are traced on the inferior surface of the penis, the, 
extremities being about 1J to 1J inches apart. The base of these 
incisions is united by a transverse incision, and the triangle of skin thus 
delimited is lemovecl. Ihe subjacent tissues are then excised, layer 
b y la yei, ovei the space covered by this wound until the urethra is 
tiG. 173.—Amputation of the penis showing stump and urethral orifice. 
exposed. This is opened at the lower margin of the wound by a 
tiansveise section. The catheter is then removed, and a grooved director 
passed into the exposed end of the divided urethra, the groove being 
directed towards the lower surface of the tube, and the urethra is divided 
with the bistoury along its middle line throughout the entire length 
of the part exposed. It is next divided transversely, and each flap of 
the mucous membrane of the urethra united to the corresponding flap 
of the skin of the penis by silk sutures. The operation is completed 
by applying, just at the base of the wound, four or five turns of a tightly- 
stietched rubber cord. The ends of the cord are fastened together, and 
the penis divided an inch or so below with a single cut (fig. 172). 
With the method referred to a mass of dead tissue remains for 
several days adherent to the end of the penis. Any risk of infection is 
prevented by antiseptic irrigation. The dead mass and ligature fall 
away between the sixth and tenth days. The stump is then usually 
