Genito-urinary surgery and venereal diseases / by J. William White and Edward Martin.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Genito-urinary surgery and venereal diseases / by J. William White and Edward Martin. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    The lax vascular subcutaneous tissue readily becomes cedematous either from local or from general causes, especially in the region of the foreskin. The delicate richly innervated skin is extremely sensitive to irri- tants. Anomalies of the Penis are rarely observed unassociated with other malformations. A large percentage of those thus afflicted are mentally deficient. The penis may be absent, concealed, minute, gigantic, double, twisted, or adherent. Absence of the Penis.—This anomaly is practically unknown, except in very young children afflicted with other and more pro- nounced malformations, such as spina bifida, and hence rarely sur- viving any great length of time. Yet Demarquay quotes the case of a patient who had reached the age of twenty-seven when he sought medical advice for the relief of an acute orchitis. The urethra opened into the anus, and there was in the perineum, just anterior to the anus, a small wart-like projection of erectile tissue. Venereal excite- ment caused this tissue to become turgid, and, if sufficiently prolonged, was followed by escape of semen through the urethra. Concealed Penis—Absence of the penis may be seeming only, the organ being concealed beneath the surface. In one such case an incision freed the organ and enabled the infant, who was suffering from retention of urine, to pass his water. Treatment of the malformation is usually unnecessary, since con- comitant deformities will first require care. When, however, there is a chance for survival, opportunity should be taken to search thor- oughly for a concealed rudimentary penis. This, if found, should be' dissected' free, and, by plastic operation, covered with integument derived from the surrounding parts. Micropenis.—Arrested growth of an otherwise perfectly formed penis is by no means uncommon, though this rarely produces results so marked that the condition may be properly termed anomalous. In general terms it may be stated that a flaccid adult penis less than two inches in circumference and two and a half inches in length is abnormal, though even in such a case the erectile tissue may be dilatable to an unusual degree, thus making the organ normal in size when in a condition of physiological activity. In some reported cases the penis has varied in size from that of a quill to that of the last two joints of the little finger. As seen in adults, stunting of the. penis is perhaps more com- monly due to excessive masturbation or to other causes interfering with development than to congenital defect.