. The principles and practice of surgery. Urethroplasty. (N61aton.) Urethroplasty. (Clark.) Incisions. Operation completed. Ricord suggests that in case of a penile fistula, where no perineal fistulaexists, which might serve as a diverticulum, it would be proper topuncture the bladder from the rectum, and maintain the urinary dis-charge in this direction until the penile fistula was cured ; after whichthe vesical fistula might be left to close of itself. Shortening of the Fraenum. Either as a congenital abnormity, or as the result of the irregularcicatrization of a chancre, the penis is someti
. The principles and practice of surgery. Urethroplasty. (N61aton.) Urethroplasty. (Clark.) Incisions. Operation completed. Ricord suggests that in case of a penile fistula, where no perineal fistulaexists, which might serve as a diverticulum, it would be proper topuncture the bladder from the rectum, and maintain the urinary dis-charge in this direction until the penile fistula was cured ; after whichthe vesical fistula might be left to close of itself. Shortening of the Fraenum. Either as a congenital abnormity, or as the result of the irregularcicatrization of a chancre, the penis is sometimes bridled by the fraenum,so that it assumes a dorsal curvature during erection. We have givenrelief in several examples of this kind, by cutting the fraenum, and,after separating the edges freely by traction upon the glans, closing the. phimosis,, 797 wound from side to side, in the direction of the circumference of thepenis, with two or three fine sutures. Phimosis, R. phimosis exists occasionally to such a decree as todemand immediate interference; the preputial orifice bein» com-pletely or almost completely closed. In such cases the surgeon oughtnot to be satisfied with a simple incision which shall give temporaryrelief, but he should proceed at once to make whatever operation maybe required to insure in the future full and permanent immunity. If the prepuce is simply contracted at its extremity,and not elongated, it will be sufficient to make a single Flg386- longitudinal slit through the dorsal surface of the integu-ment and mucous membrane. The precise method ofprocedure is as follows :— Upon a grooved director, a narrow, sharp-pointed bis-toury is carried almost to the point where the mucous mem-brane is reflected upon itself behind the corona glandis,and from thence it is thrust forward throug
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