. Manual of operative surgery. xtended backalong the dorsum of the penis until sufl&cienttissue is obtained, where the two incisions areconnected by a transverse one, and the flap ofskin lifted but left attached to the cervix by theinner surface. Several sutures now close thelateral integument over the denuded area (Fig. 895).The pedunculated flap of prepuce is constructedinto a tube with its skin or outer surface inside,by means of a number of catgut sutures. Thepenis is tunneled by means of a narrow bistoury or medium trocarand cannula, through the glans, above its groove, along the penis to
. Manual of operative surgery. xtended backalong the dorsum of the penis until sufl&cienttissue is obtained, where the two incisions areconnected by a transverse one, and the flap ofskin lifted but left attached to the cervix by theinner surface. Several sutures now close thelateral integument over the denuded area (Fig. 895).The pedunculated flap of prepuce is constructedinto a tube with its skin or outer surface inside,by means of a number of catgut sutures. Thepenis is tunneled by means of a narrow bistoury or medium trocarand cannula, through the glans, above its groove, along the penis toa point beneath the hypospadiac opening, when it is made to emergeat one side of, but close to, the urethra; the tube of prepuce is drawnthrough the tunmel and sutured where it enters the glans and alsowhere it emerges (Fig. 8g6). At the end of ten days the pedicle of the flapis cut through close to the new meatus. The second operation, made at alater period, consists of a perineal opening into the urethra and insertion of. Fig. 897.—(C. H. Mayo.) AMPUTATION PENIS 733 a Pezzers self-retaining female catheter; this is the least irritating form ofcatheter and can be left as long as needed—usually from five to eight incision at the termination of the two urethras now admits of accuratecoaptation by sutures, or the normal urethra may be mobilized (Beck method)to a sufficient extent to admit of its insertion into the new urethra, whereit is held by sutures and the external parts closed over this (Fig. 897). Oc-casionally a little urine escapes into the urethra, and the entire canal is bestdrained by passing several strands of silkworm-gut or horse-hair through theurethra and out alongside the catheter in the perineal opening. CHAPTER LIVAMPUTATION OF PENIS Partial Amputation.—I. Amputation of Glans and Fart of Penis.—Step i.—Apply an elastic constrictor to the root of the penis. Make an incision throughthe skin completely round the penis and at least ^^ inch distan
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