Urethral subincision

A little-known surgical procedure - subincision of the urethra - is an operation in which the lower surface of the penis is longitudinally cut along with the urethra, from the urethral mouth to the base. Such a modification of the penis in some nations of the world is of a ritual nature: subincision was especially prevalent 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 shown in emergency situations, with the urgent need to introduce a catheter and the inability to do so.

Indications for the procedure

Ritual changes of the body always were inherent in basically to the tribal people - Africa, Australia. Historians claim that for the first time Australian aborigines began to practice subincision of the urethra. This operation pursued several goals at once:

• exit from the urethra after subincision was shifted to the base of the penis, which reduced the likelihood of sperm penetration into the vagina during sexual contact; in turn, the number of pregnancies decreased markedly - that is, subincision can be called an ancient contraceptive to some extent;
• because of the dissected urethra, its mouth fell to the base of the penis, so the man could no longer urinate standing up, but had to squat like a woman; these men wanted to point out their intimacy and union with women.

In the modern world, bodily modifications of the subincision type represent a certain “trend of fashion”, if you can call it that. In medicine, subincision is also used, but extremely rarely: in most cases, instead of this procedure, a urethrotomy is performed - a small endoscopic dissection of the urethral canal. The operation is necessary to eliminate the stricture - a critical narrowing of the urethra. This 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, the medical subincision of the urethra is prescribed only for health reasons.

[1], [2], [3]

Preparation

It is unlikely that the Australian aborigines in any way specifically prepared for the ritual subincision of the urethra. Scientists say that boys who have reached puberty were first performed like ritual circumcision, and only a few months later (after tissue healing), a subincision ceremony was performed.

In medicine, preparation is necessarily preceded by operations, and it looks like this:

• The doctor prescribes the patient a referral for a complete blood and urine test, a coagulogram (to determine the quality of blood clotting and the duration of bleeding). In addition, a smear is taken for the presence of an infection, a bakposev uric fluid, fluorography is performed. According to the results of the analysis, conclusions are drawn about the absence of contraindications for subincision.
• It is undesirable to take food and drinks for 6-8 hours before the procedure (this point should be clarified with the doctor, since this stage depends largely on what method of anesthesia will be used).
• The next morning the patient should take a shower, thoroughly wash and shave the external genitals.
• In the clinic with you must take the results of the tests. It is also desirable that the patient is accompanied by one of the relatives: it is possible that the person will need additional support and help after the operation of subintizing the urethra.

[4], [5], [6]

Technique of the urethral subincises

The procedure for subincision in the Australian tribe, saloon and in a medical institution is significantly different.

The ritual subincision of the urethra is as follows: the teenager is laid on his back, the tribal elder sits on his chest (facing the genitals) and inserts a rod carved from the tree into the urethra (he plays the role of a kind of "substrate" so that the knife does not cut the "extra" tissue ). Next, using a knife, an incision is made in the lower part of the penis from the urethra to the scrotum. Of course, such a spectacle is difficult to imagine in the modern world. However, experts say that such ceremonies are still practiced among the indigenous people of Mardujar.

The subincision of a member in a clinical institution is a completely different process, which occurs in compliance with all the rules of operation, with the use of asepsis and antisepsis:

• a sterile metal catheter is inserted into the urethra;
• using a surgical instrument (optional surgeon - it can be a scalpel or scissors), an incision is made along the midline of the ventral surface of the penis - in fact, this is subincision;
• the doctor checks for sufficient depth using an indirect metal catheter or a bougie;
• measures are taken to stop the bleeding from the wound;
• seams if necessary;
• The wound surface is treated with an antiseptic, an aseptic dressing is applied.

Full subincision implies dissection of the penis along with the urethra from its mouth to the scrotum.

Partial subincision implies an incomplete incision: about 2.5-3 cm from the exit of the urethra. This procedure with strictures is practiced more often if there is no possibility of urethrotomy or meatotomy.

Subincision and metotomy are somewhat different concepts. So, the metotomy involves the smallest incision according to the type of dissection of the urethral orifice, which allows to expand it to the required size. Subincision and meatotomy are also used, both in medicine and in terms of bodily modifications - in special salons, where, among other things, you can get a tattoo, piercing, scarification, branding, cutting the tongue and other difficult to explain transformations with the body.

By the way, a metotomy may also be an accidental phenomenon — for example, a consequence of a genital piercing.

Subincision or dissection of the urethra in official medicine is used extremely rarely and only for health reasons: to correct problems with the exit of urinary or seminal fluids, to improve the quality of life of the patient.

Contraindications to the procedure

It is forbidden to subintize the urethra:

• 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 states.

Some contraindications to subincision are relative: after their elimination it is allowed to start the operation.

[7]

Consequences after the procedure

Any surgical intervention has some degree of risk of developing unpleasant consequences and complications. Conducting subincisation of the urethra can also leave behind undesirable effects:

• recurrent stricture development (urethral contraction);
• penetration of irrigation fluid in the nearurethral space;
• pronounced scar tissue changes;
• periodic pulling soreness in the penis;
• changes, erectile dysfunction;
• libido change.

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

[8], [9], [10]

Complications after the procedure

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

• The development of purulent processes, the defeat of the urethra (the state is accompanied by fever, weakness, nausea, pain in the head).
• The formation of unaesthetic scars.
• Bleeding in the area of resection, lymphatic edema.
• Inflammation of the bladder, ascending infection.
• Blockage of the urethral canal with blood clots.

In order to avoid complications, the procedure of subincision should be carried out by an experienced skilled technician. It is equally important to observe all the details of the postoperative care of the wound surface.

[11]

Care after the procedure

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

As a rule, in the initial 2-3 days after the operative subincision, the sexual organ has a swollen and bluish appearance, and a small amount of serous fluid is released from the wound. This is considered normal and does not require medical intervention. With the appearance of severe pain appeal to the doctor is necessary.

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

• The first dressing is done 24-48 hours after surgery. Previously, you can not touch the bandages!
• Dressings are repeated regularly, depending on the recommendations of the doctor. The frequency of dressing changes can vary from 3 times a day to once.
• If necessary, hydrogen peroxide, furatsilina solution, etc. Are used when changing the dressing. These solutions will help to remove the bandage easily, without damaging the delicate skin of the penis.
• It is advisable to adhere to bed rest during the first 3-4 days after subincision.

In order to prevent infection in the wound and the development of inflammation, the penis is treated with special preparations to accelerate tissue regeneration. Such drugs are prescribed by a doctor, their independent use is unacceptable.

• Drugs that are used to facilitate dressings and for treating wounds after urethral subincision are:

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

• Antibacterial ointment:

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

Ointment is applied up to 3 times a day with a clean cotton swab, without pressure and rubbing, under the bandage. Duration of use - no more than 3-4 days.

• Revitalizing and anti-inflammatory external agents:

1. Aktovegin;
2. Betadine;
3. Baneocin.

The use of such means is allowed not earlier than 3-4 days after the subrequisite of the urethra, when the wound is covered with granulation. The drug is applied thinly on clean and dry skin, twice a day.

Care is carried out only in special disposable latex gloves. Ligation is carried out with the help of sterile bandages or napkins.

Subincision of the urethra is a simple intervention. However, the period of tissue repair after the procedure is quite long. Therefore, hygiene with constant monitoring of the patient's well-being is obligatory.

[12], [13]

Reviews

In the modern world, men perform subincision of the urethra with and without indications. For example, some decide on such a bodily modification to enhance the sensitivity of the penis, to increase the "sharpness of sensations", as well as for aesthetic, philosophical or fetishistic considerations. Conducting such a procedure is not approved by medical specialists, because this operation leads to irreparable consequences, and its safety is controversial.

It’s another thing if the subincretion of the urethra is done for medical reasons: it happens very rarely, and doctors do everything possible to avoid this procedure. Pre-prescribed conservative treatment. If it turns out to be ineffective, then resort to a metotomy or urethrotomy.

It is impossible to prohibit a person to carry out certain modifications with his body: this is a private matter of each patient. However, experts advise: subintizing the urethra is both a simple and complex operation, and it is hardly worth doing it unless absolutely necessary. After all, what is given to man by nature is the best for the organism and its health.