The practice of surgery . lly ispracticable, in recent cases. The patients trunk having been steadied,and the parts well oiled, the surgeon grasps the glans with the fingersof the right hand, and makes steady pressure thereon, also pushing itsteadily from him ; at the same time, with the fingers of the left hand,he draws forward the constricting orifice; the object being to push theglans, diminished by pressure, through the narrow preputial orifice. Failing in this, and there being no marked urgency, another mode ofreduction may be attempted. The penis is placed erect, and on theglans a stream
The practice of surgery . lly ispracticable, in recent cases. The patients trunk having been steadied,and the parts well oiled, the surgeon grasps the glans with the fingersof the right hand, and makes steady pressure thereon, also pushing itsteadily from him ; at the same time, with the fingers of the left hand,he draws forward the constricting orifice; the object being to push theglans, diminished by pressure, through the narrow preputial orifice. Failing in this, and there being no marked urgency, another mode ofreduction may be attempted. The penis is placed erect, and on theglans a stream of cold water is maintained for some time. This mayhave the effect of so diminishing the bulk of the formerly turgid part,as to admit of its being replaced without much difficulty within its pre-putial covering. But should these attempts at simple reduction fail, or should the casebe already so far advanced as not to warrant their being practised, in-cision is required. And little more than a scratch suffices, if rightly. 588 HYPOSPADIAS. Fig. 245. placed. The general bulge behind the glans is not to be widely laid open; but it is separated, bymeans of the fingers, into its two component the depth between these, the constriction isfound, as a narrow band or thread; and that alonerequires division. After reduction, the woundseems a mere notch in the preputial verge. If neglected, the glans may slough or ulceratevery destructively ; or, the glans remaining merelycongested, the stricture may cause ulceration ofthe body of the penis, opening the urethra, andp^hymosis; the dark producing urinary fistula. Operating lately on aportion is the lining of the case of this kind, in a boy, after the paraphimosisprepuce, reflected; the pre- }ia(j existed unreduced for three months, I dividedrtricLrisbeWnd^Seen a piece of thread which encircled the penis—deeplythe two swellings. imbedded in it—and which had been secretly ap- plied as a jugum, to preveitt punishment on accountof
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