Urethral subincisión

A little-known surgical procedure, urethral subincision, is an operation in which the underside of the penis is cut longitudinally along with the urethra, from the opening of the urethra to the base. This modification of the penis is ritualistic in some nations: subincision is especially widespread in Australia, African countries, some regions of Latin America and Polynesia.

Rarely, but subincision can also be used in official medicine: the operation can be indicated in emergency situations, when there is an urgent need to insert a catheter and it is impossible to do so.

Indications for the procedure

Ritual changes to one's body have always been characteristic mainly of tribal peoples - Africa, Australia. Historians claim that Australian aborigines were the first to practice urethral subincision. This operation pursued several goals at once:

• the exit from the urethra after subincision shifted to the base of the penis, which reduced the likelihood of sperm penetrating into the vagina during sexual intercourse; in turn, the number of pregnancies significantly decreased - that is, subincision can be called an ancient contraceptive to some extent;
• Because of the cut urethra, its mouth descended to the base of the penis, so a man could no longer urinate standing up, but was forced to squat like a woman; by this, men wanted to indicate their closeness and unity with women.

In the modern world, body modifications such as subincision are a certain "fashion fad", if you can call it that. In medicine, subincision is also used, but very rarely: in the vast majority of cases, urethrotomy is performed instead of this procedure - a small endoscopic dissection of the urethral canal. The operation is necessary to eliminate stricture - a critical narrowing of the urethra. Such a pathology can occur as a result of chronic inflammation of the prostate gland, as well as gonorrhea or mechanical damage to the urethra. That is, medical subincision of the urethra is prescribed only for vital indications.

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Preparation

It is unlikely that the Australian Aborigines prepared in any special way for the ritual subincision of the urethra. Scientists claim that boys who reached puberty were first given a similar ritual circumcision, and only after several months (after the tissues had healed) was the subincision rite performed.

In medicine, operations are always preceded by preparation, and it looks something like this:

• The doctor writes out a referral for the patient for a general blood and urine test, a coagulogram (to determine the quality of blood clotting and the duration of bleeding). Additionally, a smear is taken for the presence of infection, a bacterial culture of urine fluid, and fluorography is performed. Based on the test results, conclusions are made about the absence of contraindications to subincision.
• It is not advisable to eat or drink anything 6-8 hours before the procedure (this point should be clarified with your doctor, since this stage largely depends on the method of anesthesia that will be used).
• The morning of the surgery, the patient must take a shower, wash thoroughly and shave the external genitalia.
• It is necessary to bring the results of the tests with you to the clinic. It is also desirable that the patient be accompanied by a relative: it is possible that the person will need additional support and assistance after the urethral subincision surgery.

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Technique urethral subincisión

The subincision procedure is performed in an Australian tribe, a salon and a medical facility, and it varies significantly.

Ritual subincision of the urethra is performed as follows: the teenager is laid on his back, the elder of the tribe sits on his chest (facing the genitals) and inserts a wooden rod into the urethra (it acts as a kind of "substrate" so that the knife does not cut "extra" tissue). Then, using a knife, an incision is made in the lower part of the penis from the mouth of the urethra to the scrotum. Of course, such a spectacle is difficult to imagine in the modern world. However, experts claim that such ceremonies are still practiced by the indigenous population of Mardudjar.

Subincision of the penis in a clinical institution is a completely different process, which takes place in compliance with all the rules of the operation, using asepsis and antisepsis:

• a sterile metal catheter is inserted into the urethra;
• using a surgical instrument (at the surgeon’s discretion – this could be a scalpel or scissors), an incision is made along the midline of the ventral surface of the penis – this is actually subincision;
• The doctor checks whether the depth is sufficient using an indirect metal catheter or bougie;
• measures are taken to stop bleeding from the wound;
• if necessary, stitches are applied;
• The wound surface is treated with an antiseptic and an aseptic dressing is applied.

Complete subincision involves cutting the penis together with the urethra from its mouth to the scrotum.

Partial subincision involves making an incomplete incision: approximately 2.5-3 cm from the opening of the urethra. This procedure is more often used for strictures if urethrotomy or meatotomy is not possible.

Subincision and meatotomy are slightly different concepts. Thus, meatotomy involves making the smallest incision, like cutting the urethral opening, which allows you to expand it to the required size. Both subincision and meatotomy are also used in medicine and in terms of body modifications - in special salons where, among other things, you can get a tattoo, piercing, scarification, branding, tongue cutting and other difficult to explain body transformations.

By the way, meatotomy may also be an accidental occurrence – for example, a consequence of genital piercing.

Subincision or dissection of the urethra is used extremely rarely in official medicine and only for vital indications: to correct problems with the release of urine or seminal fluids, to improve the patient's quality of life.

Contraindications to the procedure

Subincision of the urethra is prohibited:

• in the presence of acute inflammatory reactions in the urogenital tract (with urethritis, cystitis, pyelonephritis, etc.);
• for any abscesses and other purulent inflammatory processes;
• at elevated body temperature, fever, decompensated conditions.

Some contraindications to subincision are relative: after they are eliminated, the operation is allowed to proceed.

Consequences after the procedure

Any surgical intervention has a certain degree of risk of developing unpleasant consequences and complications. Subincision of the urethra can also leave behind undesirable consequences:

• recurrence of stricture (urethral narrowing);
• entry of irrigation fluid into the periurethral space;
• pronounced cicatricial changes in tissues;
• periodic pulling pain in the penis;
• changes, disorders of erectile function;
• changes in libido.

Some consequences of subincision can directly affect the patient's health and are considered complications of this intervention.

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Complications after the procedure

Subincision of the urethra does not always proceed smoothly: complications may develop:

• Development of purulent processes, damage to the urinary tract (the condition is accompanied by fever, weakness, nausea, headache).
• Formation of unaesthetic scars.
• Bleeding in the resection area, lymphatic edema.
• Inflammation of the bladder, ascending infection.
• Blockage of the urethral canal by blood clots.

In order to avoid complications, the subincision procedure should be performed by an experienced qualified specialist. It is equally important to observe all the subtleties of postoperative care of the wound surface.

Care after the procedure

Properly organized care after subincision is very important to ensure that the recovery period goes without complications. This will reduce pain in the penis and prevent the development of adhesions, infection and bleeding.

As a rule, in the first 2-3 days after surgical subincision, the genital organ has an edematous and bluish appearance, and a small amount of serous fluid is released from the wound. This is considered a normal phenomenon that does not require medical intervention. If severe pain occurs, it is necessary to consult a doctor.

In general, healing takes 2-5 weeks. It is very important to carefully observe the rules of genital hygiene for 4-12 weeks after subincision.

• The first dressing is done 24-48 hours after the surgery. You can't touch the bandages before that!
• Dressings are repeated regularly, depending on the doctor's recommendations. The frequency of dressing changes can vary from 3 times a day to once.
• If necessary, hydrogen peroxide, furacilin solution, etc. are used when changing the bandage. These solutions will help remove the bandage easily, without damaging the delicate skin of the genitals.
• It is advisable to stay in bed for the first 3-4 days after subincision.

In order to prevent infection from entering the wound and inflammation from developing, the penis is treated with special preparations to accelerate tissue regeneration. Such preparations are prescribed by a doctor; their independent use is unacceptable.

• Preparations that are used to facilitate dressings and to treat the wound after urethral subincision:

1. furacilin solution (proportion 1 tablet per 100 ml of water);
2. infusion of chamomile or sage;
3. Betadine (proportion 1 ml per 100 ml of water);
4. hydrogen peroxide 3%;

• Antibacterial ointments:

1. Levomekol;
2. tetracycline ointment;
3. Geoxizone.

The ointments are applied up to 3 times a day with a clean cotton swab, without pressing or rubbing, under a bandage. The duration of use is no more than 3-4 days.

• Restorative and anti-inflammatory external agents:

1. Actovegin;
2. Betadine;
3. Baneocin.

The use of such products is allowed no earlier than 3-4 days after the urethral subincision, when the wound is covered with granulation. The drug is applied thinly to clean and dry skin, twice a day.

Care is carried out only in special disposable latex gloves. Bandaging is carried out using sterile bandages or napkins.

Urethral subincision is a simple procedure. However, the period of tissue recovery after the procedure is quite long. Therefore, hygiene with constant monitoring of the patient's well-being is mandatory.

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Reviews

In the modern world, men undergo urethral subincision with or without indications. For example, some decide on such a bodily modification to increase penis sensitivity, to increase the "sharpness of sensations", as well as for aesthetic, philosophical or fetishistic reasons. Carrying out such a procedure is not approved by medical professionals, because this operation leads to irreparable consequences, and its safety is questionable.

It is a different matter if urethral subincision is done for medical reasons: this happens extremely rarely, and doctors do everything possible to avoid this procedure. Conservative treatment is prescribed in advance. If it is ineffective, then they resort to meatotomy or urethrotomy.

It is impossible to prohibit a person from making certain modifications to their body: this is a personal matter for each patient. However, experts advise: urethral subincision is both a simple and complex operation, and it is unlikely to be done without extreme necessity. After all, what is given to a person by nature is the best for the body and its health.