Plastic surgery; its principles and practice . f a perineal fistula throughwhich the bladder is drained during the operative procedure on the urethra. {2) The Straightening of the Penis.—This is accomplished bydividing the corpora cavernosa close to the pubes, after which the penisis held down with a splint for several weeks. If the division of thecorpora is not sufficient, more extensive dissection and excision of thecontracted tissues must be carried out. i 310 EPISPADIAS 311 The classical operation of Thiersch for the relief of complete epispa-dias is as follows: (i) The Construction of a U
Plastic surgery; its principles and practice . f a perineal fistula throughwhich the bladder is drained during the operative procedure on the urethra. {2) The Straightening of the Penis.—This is accomplished bydividing the corpora cavernosa close to the pubes, after which the penisis held down with a splint for several weeks. If the division of thecorpora is not sufficient, more extensive dissection and excision of thecontracted tissues must be carried out. i 310 EPISPADIAS 311 The classical operation of Thiersch for the relief of complete epispa-dias is as follows: (i) The Construction of a Urethra in the Glans Penis.—Two deep incisions are made parallel to the urethral groove (Fig. 2^2, A and B).A glass rod is laid along the groove and the spongy tissue is presseddown. The lateral flaps are then sutured over the rod. (2) Construction of the Penile Urethra.—After healing is completein the glans, two quadrilateral flaps are raised along the whole lengthof the urethral groove, the flap A (Fig. 273) having its base next to the. Fig. 273. Fig. 274. Fig. 273.—Thierschs operation for epispadias, continued {Binnie).—-i and 2. Methodof constructing the penile urethra. Fig. 274.—Thierschs operation for epispadias, continued.— i and 2. Method of con-necting the newly formed channel. groove, and the flap B having its base away from the groove. Theflap A is turned over (skin surface down), and is sutured under flap Bnear its base. Flap B is then shifted over flap A and its edge is suturedto the raw edge left on the skin of the penis when flap A was raised. (3) The Opening Between the Penile and Glandular Portions of theUrethra is Then Closed by Utilizing the Redimdant Prepuce.—A trans-verse incision CC is made through the prepuce near its base (Fig. 274, i)and the glans is pushed through this opening, and the defect is closedby suturing the freshened edges of the penile and glandular urethra tothe prepuce. (4) The Epispadial Opening Is Closed with a Pedunculate
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgeryplastic, booky
