The Penis. Malformations Of The Penis

The penis may be absent, undeveloped, or, what is very rare, double. There may be lack of closure of the urethra on the dorsal surface, epispadias, or, on the under side, hypospadias. In the latter condition the cleft may extend posteriorly and separate the scrotum into two lateral halves. This is usually the condition in the cases of hermaphrodism. Epispadias may be associated with exstrophy of the bladder. The prepuce may be absent or, what is quite common, elongated and the orifice greatly narrowed; is termed phimosis.

Inflammation of the glans penis is known as balanitis, of the prepuce as posthitis, of the two together as balano-posthitis. Is generally the result of uncleanliness. Is a quite common complication in phimosis when the prepuce cannot be retracted. The smegma and urine undergo decomposition and set up an inflammation; infection, as in gonorrhea, may be the cause. Occasionally the prepuce when inflamed may be retracted behind the glans and unable to be drawn forward. Is called paraphimosis, and by its constriction may give rise to serious secondary conditions.

Injuries to the penis may give rise to hemorrhage or to rupture. If it becomes infected suppuration and gangrene may result. If the urethra has been lacerated extravasation of urine with its accompanying symptoms may occur. Injuries are likely to be more severe when the penis is in an erect condition.

Tuberculosis is rare. It appears as ulcerations on the glans with cicatrization and necrosis.

Syphilis generally makes its initial appearance on the penis as the true chancre.

Tumors of the penis are frequently found and are generally epithelial in structure. The papilloma or condyloma appears as a hard, rough, cauliflower-like growth upon the glans penis or prepuce. Is composed of vascular connective-tissue villosities covered by squamous epithelium. Carcinoma usually occurs in the form of the squamous epithelioma arising from the glans or the prepuce. It is generally warty and prone to ulcerate. Large areas of the penis may be destroyed and metastases to the neighboring inguinal lymph-nodes occur. The connective-tissue tumors are rare.

Scrotum

Is quite frequently the seat of epithelioma in chimney-sweepers and paraffin-workers. Elephantiasis is common in the East and in many cases is due to the filariae. The subcutaneous tissue is greatly increased, so that an extreme enlargement may occur. Dermoid cysts are occasionally met with.