Text Appearing Before Image: dropped into the abdominal cavity. Care must then be taken to isolate the layers of theabdominal wall because the latter is bound to be defective in these cases, andif this precaution is not taken a ventral hernia is very likely to result. This SUKGERY OF THE GENITO-URINARY TRACT 571 condition later resulted in the formation of a strangulated hernia in one of ourcases which eventuated in the death of the patient. After these layers havebeen carefully isolated the abdominal wall is closed in the manner described inthe section on abdominal surgery. It is of great importance in these cases to strap the wound thoroughly withrubber adhesive straps, in order to remove the tension as much as possiblefrom the stitches in the abdominal wound. It is also important to administerfor the first two weeks after the operation only such food as will give rise tothe formation of as little gas as possible, in order to reduce the strain upon thestitches of the abdominal wound to a minimum. The stretching of the Text Appearing After Image: Complete Excision of Male Genitalia for Carcinoma of Penis. 1, urethra; 2, vascular portion of penis; 3, vessels of cord; 4, vas deferens. Showingurethral stump transplanted into perineum through buttonhole, the end proiecting 5 mm. sphincter ani muscle in the beginning of the operation will aid in preventingaccumulation of gas and will reduce the pressure upon the wound in the intes-tine. Should, however, the sphincter contract sooner than desirable a rectaltube should be inserted and kept freely open, in order to prevent the accumu-lation of flatus in the rectum. These patients are very comfortable after the operation. They are able toremain perfectly dry, sleep all night and evacuate the urine from the rectum asoften as they would normally evacuate the bladder. They are no longer offen-sive to themselves or their friends and neighbors and they and their familieslook upon the operation as a great blessing. It is important not to injure the ostium of the ureter, and for this reason 5
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