Remarkable case of extrophy of the urinary bladder, with remarks / by P.D. Handyside.

Date:
[1839?]
Catalogue details

Licence: Public Domain Mark

Credit: Remarkable case of extrophy of the urinary bladder, with remarks / by P.D. Handyside. 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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    to be present throughout, although the summits of their spine are widely separated from each other to the distance of seven inches and a half, and are apart from the mesial line half that distance. The recti muscles of the abdomen maintain their ordinary at- tachments to bone, but five inches above the tumour their mesial margins fonn, with the superior margin of the neck of the tumour, a triangular space, the area of which corresponds with the expand- ed linea alba, and that cicatrized spot formerly described as marking the seat of the umbilicus. The pyramidales muscles arc of course wanting. The remaining measurements of the pelvis are the following: Between the anterior superior iliac spines across the hypogastrium, 14 inches; do. on a plane surface, 12^ inches; do. across the last lumbar spine, 16^ inches; between the anterior superior iliac spine and the pubic spine, 5 inches; between the tuberosi- ties of the ischium, 4|- inches. Again, the distance of the scro- biculus cordis from the neck of the tumour is W\ inches ; the latter from the pubic spine, 2 inches ; from the anterior superior iliac spine, 6 inches; and from the os coccygis, 6^ inches. The penis is adherent to the trigone of the everted bladder, but the glans alone is perceptible, which is cleft and imperforate. In length it is an inch and a half, in breadth two inches, and in depth (laterally to the frcenal cleft) seven-eighths of an inch. The anterior two-thirds of its upper surface or dorsum present a flat- tened shallow groove or gutter, on which the urine in part falls, and this gutter is terminated laterally by an edge or border about a line in extent. The posterior third is surmounted by a triangu- lar elevation, exquisitely sensitive, resembling and corresponding to the verumontanum urethrce. The orifices of the two seminal ducts are situated at three-eighths of an inch distance from each other, and three-fourths of an inch from the side of the penis, and they open on the verumontanum; while on and around thiselevation are several mucous lacunae besides, one of which, placed in front, resembles the lacuna magna in its size, and in its extending backwards. The glans penis is devoid of preputial covering above, but below it is invested by prepuce, which anteriorly form a corrugated semilunar frcenum, and laterally is prolonged upon the integument of the scrotum. The glans is capable of erec- tion ; in colour it is natural; the verumontanum and urethral groove present also their natural bright rose-tint. The corpora cavernosa are not distinguishable. The penis does not arise from bone through the medium of crura, but is attached to a dense ligamentous band, that may be felt by the finger introdu- ced per anum, extending transversely across between the ascend- ing rami of the pubes. These ridges of bone are four inches dis-