Irish journal of medical science . of hypospadias,still the contracted orifice (Fig. 8) was nearly in the axis of thenormally situated opening. Tig. 8.—Glans penis and the contracted orifice, which was surrounded by dense cicatricial substance. Where the prepuce was deficient, laterally and inferiorly, therewere unmistakable evidences of previous ulcerations. A good dealof gleety discharge flowed from the urethra. 22nd June.—With considerable difficulty I passed a small bougie By Me. Kiciiardson. 19 through the orifice and on to the bladder- The point of thisinstrument is not more than No. i o
Irish journal of medical science . of hypospadias,still the contracted orifice (Fig. 8) was nearly in the axis of thenormally situated opening. Tig. 8.—Glans penis and the contracted orifice, which was surrounded by dense cicatricial substance. Where the prepuce was deficient, laterally and inferiorly, therewere unmistakable evidences of previous ulcerations. A good dealof gleety discharge flowed from the urethra. 22nd June.—With considerable difficulty I passed a small bougie By Me. Kiciiardson. 19 through the orifice and on to the bladder- The point of thisinstrument is not more than No. i of Weisss gauge. On this occasion evidence was afforded to the touch that thecontraction extended from the orifice backwards for about an inchor a little more. Considering the length of the contraction I determined, in thefirst instance, to enlarge the orifice according to Colless method, andwhen the wound had been healed for a few weeks, to divide theremainder of the stricture either with the bistouri cache or Fig. 9.—Shape of the orifice and the funnelled passage formed by the operation. Colless operation (Fig. 9) was performed on the 24th June,1871, the patient being fully narcotized by chloroform. The operation was tedious, the urethral lining membrane havingto be dissected from the corpus spongiosum very slowly, so that thebleeding caused by each cut might cease before making is an important precaution to take in the operation, lest thelining membrane, when concealed by blood, be hopelessly injuredby the knife or the scissors. One small artery in the site of thefraenum was divided and had to be tied. When a sufficient amount of the corpus spongiosum had beenremoved, and bleeding had ceased, the edges of the partially detachedurethra] lining membrane were everted and secured in contact withthe margin of the cut glans by means of four fine silk interrupted•sutures (Fig. 9). The healing process was so rapid, I was enabled, althoughreluctan
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