DOCSLIB.ORG

Penile Size and Penile Enlargement Surgery: a Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Penile Size and Penile Enlargement Surgery: a Review International Journal of Impotence Research (2008) 20, 519–529 & 2008 Nature Publishing Group All rights reserved 0955-9930/08 $30.00 www.nature.com/ijir REVIEW Penile size and penile enlargement surgery: a review BE Dillon1, NB Chama1 and SC Honig2,3 1Mount Sinai School of Medicine, New York, NY, USA; 2Urology Center, New Haven, CT, USA and 3Division of Urology, University of Connecticut, Farmington, CT, USA Penile size is a considerable concern for men of all ages. Herein, we review the data on penile size and conditions that will result in penile shortening. Penile augmentation procedures are discussed, including indications, procedures and complications of penile lengthening procedures, penile girth enhancement procedures and penile skin reconstruction. International Journal of Impotence Research (2008) 20, 519–529; doi:10.1038/ijir.2008.14; published online 22 May 2008 Keywords: penis; penile shortening; penile augmentation; penile lengthening; penile girth enhancement Introduction Association sanctioned procedure, and typically both plastic surgeons and urologists perform penile Throughout history, the penis has defined masculi- enlargement procedures. The purpose of this paper nity. Discussion of the penis has been deemed taboo, is to summarize the available literature on penile socially unacceptable; and at other times, it is the size, discuss conditions that contribute to penile topic of lighthearted conversation and jokes. Length, shortening, and to highlight the indications, proce- girth and function, however, have been an issue for dures and complications of penile enlargement men throughout history. This is apparent in the first surgery. book of the Old Testament, Genesis, where Abraham is told, ‘Every male among you shall be circumcised. You shall be circumcised in the flesh of your foreskins, and it shall be a sign of the covenant Penile size between me and you.’1 The ancient Greeks were also fixated on the penis, as recorded by Kallixeinos of Paintings and writings by the ancient Greeks, as Rhodes in 275 BC, who described a ‘golden phallus, early as 200 BC suggest that they believed that a 180 feet long’. The phallus was topped with a smaller penis was superior.1 However, over the golden start and was carried through the streets course of time, with the various sexual revolutions during a festival in Alexandria, all the while people this belief has changed and for most men, larger is sung to it and recited poems.1 better and comparisons to the rest of the general Kelley and Eraklis2 performed the first recorded population matter. This is evident in the terms penile augmentation in 1971 for the treatment of ‘phallic identity’ and ‘phallocentrism’. ‘Phallic microphallus in the pediatric population. Subse- identity’, as described by Vardi, is the concept of a quently, the adult population began to show interest man seeking identity in his penis, which a focus on in the procedure for cosmetic and psychological bigger is better. Similarly, ‘phallocentrism’ is the reasons, similar to that seen with reconstructive concept that the penis is central to a man’s identity.3 breast surgery and augmentation. Penile augmenta- Penile size has been suggested to correlate to tion procedures are not an American Urological certain physical characteristics. There has been some data suggesting no correlation between shoe size and penile length by Shah and Christopher in a small 2002 study. They studied 104 men from 54 to Correspondence: Dr SC Honig, Division of Urology, University of Connecticut, 330 Orchard Street, Suite 164, 87 years of age. All penises were measured on full New Haven, CT 6511, USA. stretch and the foot size of each patient was E-mail: [email protected] recorded. After linear regression analysis, there Received 6 November 2007; revised 3 April 2008; accepted was no statistical correlation between stretched 7 April 2008; published online 22 May 2008 penile length and shoe size.4 Penile size and penile enlargement surgery BE Dillon et al 520 and flaccid conditions. They found that the average stretched length was approximately 13.1 cm (13.26 for 61 men aged 17 years, 13.11 for 71 men aged 18– 19 years and 13.02 for 54 men aged 20–25 years). In addition they found the average girth of the flaccid penis (location of measurement not mentioned) to be 8.5 cm, and the average girth of the erect penis to be 15.8 cm.7 In 1948, Kinsey published his hallmark paper on penile length, which until 2001 was the largest published series. Kinsey examined men between the ages of 20 and 59 and measured subjects in both the flaccid and the stretched flaccid states. He found that the average flaccid length was 9.7 cm and the average stretched length was 16.74 cm.8 Nearly 50 years later in 1992, Bondil et al.9 studied 905 men from age 17 to 91 years, to examine the ‘extensibility’ of the penis. Penile length was recorded in three conditions; flaccid, maximal flaccid stretched and flaccid after stretch. The maximal flaccid stretched length was achieved by pulling on the glans three times, allowing for ‘tissue viscoelasticity.’ After the penis was measured at its maximal flaccid stretched length, it was then Figure 1 Penile length from pubopenile skin to meatus and fat remeasured in its flaccid length, which they defined pad depth from pubic bone to pubopenile skin. Reprinted with as ‘flaccid after stretch’. Lengths were found to be permission from Journal of Urology. 10.7 and 16.74 cm in the flaccid and stretched states, respectively.9 They concluded that extensibility decreases with age. Specifics of measurement of penile size is im- In 1992, da Ros and colleagues published the first portant in comparing data in different papers. series examining the length of the erect penis. The Although there is no standard technique for measur- study was conducted in a group of Caucasian men ing penile size, there appears to be a consensus who were interested in penile lengthening. 150 men among researchers that penile length should be were enrolled in the study and were given an measured on the dorsum of the penis beginning intracavernosal injection of papaverine and prosta- from the pubopenile junction to the tip of the glans glandin to achieve erection, after which measure- (Figure 1).5 This measurement applies to the flaccid, ments were obtained. Measurements of girth were stretched and erect states. In addition, measure- taken both proximally and distally. The authors ments of penile girth should be obtained from the found that the average erect length in their 150 middle of the penile shaft, in all three states. For the subjects was 14.5 cm, proximal girth 11.92 cm and purpose of clarity of nomenclature, a flaccid penis is distal girth 11.05 cm.10 After data were collected, one that is unstimulated or not aroused, and would and information was shared about the ‘normal’ be seen when the man is in the normal anatomical ranges of penile length, men were no longer position. Flaccid stretched is when the flaccid penis interested in penile lengthening surgery. is pulled to its maximal distance. Lastly an erect In 1999, Bogaert and Hershberger11 investigated penis is one that is maximally stimulated, either the relationship between sexual orientation and through visual, tactile or pharmaceutical manipula- penile size. The authors had two cohorts, of 935 tion. homosexual men and 4187 heterosexual men with a To date, there have been few studies published on mean age of 30 in both groups. Self-reported penile penile size. The first reported study was conducted length was performed in five measurements; esti- by Loeb in 1899, where he examined 50 subjects, age mated erect size, flaccid penile length, erect penile ranging from 17 to 35 years. He measured the penis length, flaccid girth and erect girth. The authors only in the flaccid state and found the average size reported that there was a significant difference in to be 9.41 cm.6 It was not clearly stated how both penile length and girth in this self-reported measurements were made. In 1942, Schonfeld and mailed questionnaire population. The average flac- Bebe looked at the normal variability of penile size, cid homosexual penis was 10.41 cm as compared to both length and girth of the penis from birth to 9.83 cm for heterosexual men. The average erect maturity. With respect to penile length, measure- penis was 16.40 and 15.60 cm for homosexual men ments were recorded only in the stretched state, and heterosexual men, respectively. Furthermore, however they looked at penile girth in both the erect flaccid penile girth measurements were 9.75 cm for International Journal of Impotence Research Penile size and penile enlargement surgery BE Dillon et al 521 homosexuals and 9.40 cm for heterosexuals. Lastly, penis measured 8.60 cm (s.d. ¼ 1.50), whereas the erect girths measured 12.57 and 12.19 cm in homo- average erect penis was 14.48 cm (s.d. ¼ 1.99).13 sexual men and heterosexual men, respectively.11 In 2005, Awwad et al.14 published his series of The validity of self reported measurements needs to patients examining penile size in Jordanian men be considered when evaluating these data. with and without erectile dysfunction. In the 271 Wessells et al.5 published their data regarding ‘normal’ subjects aged 17–83 years, they found that penile length and indications for penile augmenta- flaccid length was 9.3 cm (s.d. ¼ 1.9), stretched tion. They examined penile lengths in 80 men with a length 13.5 cm (s.d. ¼ 2.3) and penile girth 8.9 cm mean age of 54 years. Patients were excluded if they (s.d.
Load more

Recommended publications
  • The Structure and Function of Breathing
    CHAPTERCONTENTS The structure-function continuum 1 Multiple Influences: biomechanical, biochemical and psychological 1 The structure and Homeostasis and heterostasis 2 OBJECTIVE AND METHODS 4 function of breathing NORMAL BREATHING 5 Respiratory benefits 5 Leon Chaitow The upper airway 5 Dinah Bradley Thenose 5 The oropharynx 13 The larynx 13 Pathological states affecting the airways 13 Normal posture and other structural THE STRUCTURE-FUNCTION considerations 14 Further structural considerations 15 CONTINUUM Kapandji's model 16 Nowhere in the body is the axiom of structure Structural features of breathing 16 governing function more apparent than in its Lung volumes and capacities 19 relation to respiration. This is also a region in Fascla and resplrstory function 20 which prolonged modifications of function - Thoracic spine and ribs 21 Discs 22 such as the inappropriate breathing pattern dis- Structural features of the ribs 22 played during hyperventilation - inevitably intercostal musculature 23 induce structural changes, for example involving Structural features of the sternum 23 Posterior thorax 23 accessory breathing muscles as well as the tho- Palpation landmarks 23 racic articulations. Ultimately, the self-perpetuat- NEURAL REGULATION OF BREATHING 24 ing cycle of functional change creating structural Chemical control of breathing 25 modification leading to reinforced dysfunctional Voluntary control of breathing 25 tendencies can become complete, from The autonomic nervous system 26 whichever direction dysfunction arrives, for Sympathetic division 27 Parasympathetic division 27 example: structural adaptations can prevent NANC system 28 normal breathing function, and abnormal breath- THE MUSCLES OF RESPIRATION 30 ing function ensures continued structural adap- Additional soft tissue influences and tational stresses leading to decompensation.
    [Show full text]
  • Phalloplasty and Urethral
    plastol na og A y Golpanian et al., Anaplastology 2016, 5:2 Anaplastology DOI: 10.4172/2161-1173.1000159 ISSN: 2161-1173 Review Article Open Access Phalloplasty and Urethral (Re)construction: A Chronological Timeline Samuel Golpanian, Kenneth A Guler, Ling Tao, Priscila G Sanchez, Klara Sputova and Christopher J Salgado* Division of Plastic Surgery, DeWitt Daughtry Family, University of Miami, Miami, FL, USA Abstract Since the first penile reconstruction in 1936, various techniques of phalloplasty and urethroplasty have been developed. These advancements have paralleled those in the field of plastic and reconstructive surgery and offer a complex patient population the opportunity of restoration of cosmetic and psychosexual function. The continuous evolution of these methods has resulted in constant improvement of the surgical techniques in use today. Here, we aim to describe a historical overview of phalloplasty and urethral (re)construction. Keywords: Phalloplasty; Urethroplasty; Reconstruction; Transgen- gender reassignment over the next 40 years. Various fasciocutaneous der; Surgery and extended pedicle island flaps were also developed during this time. Nonetheless, they continued to have suboptimal functional and Introduction aesthetic results due to their significant limitations in sensory recovery Phalloplasty is a complex surgical task. Successful creation or primarily [10,13,14]. restoration of the penis must meet certain cosmetic and functional Throughout the 1970’s other innovations were introduced in the field thresholds. The ideal neophallus should be sensate, hairless, and similar of penile reconstruction. In 1971, Kaplan et al. [15] developed a method in color to the surrounding skin. It should have an inconspicuous scar, that provided sensation to the neophallus.
    [Show full text]
  • Vertebral Column and Thorax
    Introduction to Human Osteology Chapter 4: Vertebral Column and Thorax Roberta Hall Kenneth Beals Holm Neumann Georg Neumann Gwyn Madden Revised in 1978, 1984, and 2008 The Vertebral Column and Thorax Sternum Manubrium – bone that is trapezoidal in shape, makes up the superior aspect of the sternum. Jugular notch – concave notches on either side of the superior aspect of the manubrium, for articulation with the clavicles. Corpus or body – flat, rectangular bone making up the major portion of the sternum. The lateral aspects contain the notches for the true ribs, called the costal notches. Xiphoid process – variably shaped bone found at the inferior aspect of the corpus. Process may fuse late in life to the corpus. Clavicle Sternal end – rounded end, articulates with manubrium. Acromial end – flat end, articulates with scapula. Conoid tuberosity – muscle attachment located on the inferior aspect of the shaft, pointing posteriorly. Ribs Scapulae Head Ventral surface Neck Dorsal surface Tubercle Spine Shaft Coracoid process Costal groove Acromion Glenoid fossa Axillary margin Medial angle Vertebral margin Manubrium. Left anterior aspect, right posterior aspect. Sternum and Xyphoid Process. Left anterior aspect, right posterior aspect. Clavicle. Left side. Top superior and bottom inferior. First Rib. Left superior and right inferior. Second Rib. Left inferior and right superior. Typical Rib. Left inferior and right superior. Eleventh Rib. Left posterior view and left superior view. Twelfth Rib. Top shows anterior view and bottom shows posterior view. Scapula. Left side. Top anterior and bottom posterior. Scapula. Top lateral and bottom superior. Clavicle Sternum Scapula Ribs Vertebrae Body - Development of the vertebrae can be used in aging of individuals.
    [Show full text]
  • The Foot Angiosomes As Integrated Level of Lower Limb Arterial Perfusion
    Research Article iMedPub Journals 2019 www.imedpub.com Journal of Vascular and Endovascular Therapy Vol. 4 No. 1: 7 The Foot Angiosomes as Integrated Level of Alexandrescu VA1* Pottier M1, Lower Limb Arterial Perfusion: Amendments Balthazar S2 and Azdad K3 for Chronic Limb Threatening Ischemia 1Department of Vascular and Thoracic Presentations Surgery, Princess Paola Hospital, Marche- en-Famenne, Belgium 2Department of Anesthesiology, Princess Paola Hospital, Marche-en-Famenne, Belgium Abstract 3Department of Radiology, Princess Paola Introduction: The angiosome concept was initially pioneered by Taylor and Palmer in the Hospital, Marche-en-Famenne, Belgium plastic reconstructive surgery field. The authors described a reproducible model of arterial and venous distribution in humans that follows specific three-dimensional (3D) networks *Corresponding author: Vlad Adrian of tissue. The angiosome model yet represents a specific level among other staged and Alexandrescu graduated levels of harmonious arterial irrigation in the lower extremity. Specific CLTI pathologies enhance characteristic arterial branches affectation, including the angiosomal source arteries. Evaluating main atherosclerotic lesions at peculiar Levels of arterial division [email protected] may afford useful clinical information. Department of Vascular and Thoracic Method: The present study proposes a description of six levels of degressive arterial division Surgery, Princess Paola Hospital, Marche- and collateral distribution in the inferior limb, including the angiosomal stage. Following en-Famenne, Belgium succeeding perioperative 2D angiographic observations over an eight-year period, these levels (I to VI) were analyzed (including the angiosomal Level III) and summarized in attached tables. The medical files of 323 limb-threatening ischemic foot wounds (Rutherford 4-6) in 295 patients (71% men) were retrospectively reviewed.
    [Show full text]
  • Part 1 the Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3
    ECA1 7/18/06 6:30 PM Page 1 Part 1 The Thorax ECA1 7/18/06 6:30 PM Page 2 ECA1 7/18/06 6:30 PM Page 3 Surface anatomy and surface markings The experienced clinician spends much of his working life relating the surface anatomy of his patients to their deep structures (Fig. 1; see also Figs. 11 and 22). The following bony prominences can usually be palpated in the living subject (corresponding vertebral levels are given in brackets): •◊◊superior angle of the scapula (T2); •◊◊upper border of the manubrium sterni, the suprasternal notch (T2/3); •◊◊spine of the scapula (T3); •◊◊sternal angle (of Louis) — the transverse ridge at the manubrio-sternal junction (T4/5); •◊◊inferior angle of scapula (T8); •◊◊xiphisternal joint (T9); •◊◊lowest part of costal margin—10th rib (the subcostal line passes through L3). Note from Fig. 1 that the manubrium corresponds to the 3rd and 4th thoracic vertebrae and overlies the aortic arch, and that the sternum corre- sponds to the 5th to 8th vertebrae and neatly overlies the heart. Since the 1st and 12th ribs are difficult to feel, the ribs should be enu- merated from the 2nd costal cartilage, which articulates with the sternum at the angle of Louis. The spinous processes of all the thoracic vertebrae can be palpated in the midline posteriorly, but it should be remembered that the first spinous process that can be felt is that of C7 (the vertebra prominens). The position of the nipple varies considerably in the female, but in the male it usually lies in the 4th intercostal space about 4in (10cm) from the midline.
    [Show full text]
  • Phallo-After-Meta.Pdf
    SURGEON'S CORNER The Surgical Techniques and Outcomes of Secondary Phalloplasty After Metoidioplasty in Transgender Men: An International, Multi-Center Case Series Muhammed Al-Tamimi, MD,1,2,3 Garry L. Pigot, MD,2,3 Wouter B. van der Sluis, MD, PhD,1,3 Tim C. van de Grift, MBA, MD, PhD,1,3,4 R. Jeroen A. van Moorselaar, MD, PhD,2 Margriet G. Mullender, MBA, PhD,1,3,4 Romain Weigert, MD,5 Marlon E. Buncamper, MD, PhD,1,3,4,6 Müjde Özer, MD,1,3,4 Kristin B. de Haseth, MD,1,4 Miroslav L. Djordjevic, MD, PhD,7 Christopher J. Salgado, MD,8 Maud Belanger, MD, PhD,9 Sinikka Suominen, MD, PhD,10 Maija Kolehmainen, MD,10 Richard A. Santucci, MD,11 Curtis N. Crane, MD,11 Karel E. Y. Claes, MD,12 Stan Monstrey, MD, PhD,12 and Mark-Bram Bouman, MD, PhD1,3,4,6 ABSTRACT Introduction: Some transgender men express the wish to undergo genital gender-affirming surgery. Metoi- dioplasty and phalloplasty are procedures that are performed to construct a neophallus. Genital gender-affirming surgery contributes to physical well-being, but dissatisfaction with the surgical results may occur. Disadvantages of metoidioplasty are the relatively small neophallus, the inability to have penetrative sex, and often difficulty with voiding while standing. Therefore, some transgender men opt to undergo a secondary phalloplasty after metoidioplasty. Literature on secondary phalloplasty is scarce. Aim: Explore the reasons for secondary phalloplasty, describe the surgical techniques, and report on the clinical outcomes. Methods: Transgender men who underwent secondary phalloplasty after metoidioplasty were retrospectively identified in 8 gender surgery clinics (Amsterdam, Belgrade, Bordeaux, Austin, Ghent, Helsinki, Miami, and Montreal).
    [Show full text]
  • Muscles Connecting the Upper Limb to the Vertebral Column
    Muscles Connecting the Upper Limb to the Vertebral Column 1-Trapezius: O: external occiptal protuberance, superior nuchal line, ligamentum nuchae (along dorsal spine of cervical vertebra ), spines of all thoracic vertebrae and their supraspinous ligament " the extention of ligamentum nuchae ". Ins: (opposite to the Ori. Of Deltoid ) Upper fibers : Post. border lateral third of clavicle. Mid.(lateral fibers): inner surface of acromial process. Lower fibers: upper border of dorsal spine of scapula. N.S: Spinal accessory nerve (motor) and C3 and 4 (sensory) XI(11) cranial nerve (spinal part). *Note that accessory nerve = XI(11) cranial nerve which has 2 parts : cranial / spinal Action : Upper fibers :elevate the scapula. middle fibers: pull scapula medially toward the ribs (retracts). lower fibers: pull medial border of scapula downward . *anterior fibers rotates the scapula. Question 1 : to put your hand over your head what are the responsible muscles?? - Supraspinatus for initiation (0-15) or (0-18) - middle fibers of Deltoid (15 or 18 -90) - Trapezius & serratus anterior :after 90, rotation of scapula. Question 2 : to touch the acromial process of the other side which muscle is responsible , and which nerve will stop the movement of the muscle if we cut it?? -muscle: pectorals major , medial & lateral pectoral nerve. *always choose the easiest movement… 2-Latissimus dorsi : O: Iliac crest, lumbar fascia, spines of lower six thoracic vertebrae (T7-T12), lower three or four ribs, and inferior angle of scapula ,then all fibers make conversion to ins. Ins: Floor of bicipital groove of humerus. N.S: Thoracodorsal nerve (branch of post. Cord of post.
    [Show full text]
  • Analyzing At-Home Prosthesis Use in Unilateral Upper-Limb Amputees To
    2017 International Conference on Rehabilitation Robotics (ICORR) QEII Centre, London, UK, July 17-20, 2017. Analyzing At -Home Prosthesis Use in Unilateral Upper -Limb Amputees to Inform Treatment & Device Design Adam J. Spiers, Member, IEEE, Linda Resnik, and Aaron M. Dollar, Senior Member, IEEE Abstract — New upper limb prosthetic devices are continuously being developed by a variety of industrial, academic, and hobbyist groups. Yet, little research has evaluated the long term use of currently available prostheses in daily life activities, beyond laboratory or survey studies. We seek to objectively measure how experienced unilateral upper limb prosthesis-users employ their prosthetic devices and unaffected limb for manipulation during everyday activities. In particular, our goal is to create a method for evaluating all types of amputee manipulation, including non-prehensile actions beyond conventional grasp functions, as well as to examine the relative use of both limbs in unilateral and bilateral cases. This study employs a head-mounted video camera to record participant’s hands and arms as they Figure 1: A video screenshot from the head-mounted camera (for complete unstructured domestic tasks within their own homes. participant P2). A new ‘Unilateral Prosthesis-User Manipulation Taxonomy’ is presented based observations from 10 hours of recorded videos. has been a wide variety of prosthetic TDs (e.g. [4]–[6]). The taxonomy addresses manipulation actions of the intact However, follow-ups of how such devices’ are practically hand, prostheses, bilateral activities, and environmental and specifically used has been limited outside of the feature-use (affordances). Our preliminary results involved laboratory. Further motivation for the need of such tagging 23 minute segments of the full videos from 3 amputee understanding comes from well-known high prevalence rates participants using the taxonomy.
    [Show full text]
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Historical Aspects of Powered Limb Prostheses by Dudley S
    Historical Aspects of Powered Limb Prostheses by Dudley S. Childress, Ph.D. INTRODUCTION People involved in work on powered limb from the viewpoint of important meetings and prostheses may wonder if the history of this events. Control approaches, another viewpoint, field is important. My answer is that one can are considered but not emphasized. Also, the learn a lot from history. Nevertheless, Hegel perspective is from America. has said, "What history teaches us is that men never learned anything from it." Unfortunately, PROLOGUE (1915-1945) it sometimes does seem true in prosthetics that we have not always profited from past experi­ The first powered prosthesis, of which I am ences. Too many aspects of the work are never aware, was a pneumatic hand patented in Ger­ published, and the multidisciplinary nature of many in 1915.13 A drawing of an early pneu­ the field produces papers in a broad spectrum of matic hand is shown in Figure 1. Figure 2 journals that are difficult to track. Books on the shows a drawing of what I believe to be the first field are, unfortunately, not numerous. electric powered hand. These drawings were The brief history that follows is by no means published in 1919 in Ersatzglieder und Arbeit­ complete, and since some of it involves years shilfen (Substitute Limbs and Work Aids).35 that are within readers' memories, I apologize This German publication illustrates the impor­ in advance for omissions that anyone may con­ tance of history in prosthetics, containing ideas sider significant. The history is intended to en­ that are still being discovered today.
    [Show full text]
  • Patients' Guide to Phalloplasty Techniques
    Guide to phalloplasty techniques 1 Patients’ Guide to Phalloplasty Techniques The St Peter’s Andrology Centre is an independent unit offering gender reassignment surgery to female-to-male patients funded by the NHS, primarily at the Hospital of St John and St Elizabeth’s in London. The surgical team is the same as that which operates on the NHS at University College Hospital and the same treatment protocols are observed. This document outlines the various procedures performed at our unit. HYSTERECTOMY AND MASTECTOMY Many patients have already had hysterectomy and mastectomy (chest surgery) performed before being referred to us for phalloplasty surgery. Mastectomy is normally the first operation undergone by patients but there is no absolute reason why it cannot be undertaken at any stage in the process. We do not provide this service at present however. In patients undergoing pubic phalloplasty (see below) we commonly perform open hysterectomy during the course of the procedure. If an open operation is necessary prior to phalloplasty, we prefer this to be done through a midline skin incision so that the possibility of a pubic phalloplasty is not compromised later. If a radial artery phalloplasty has already been decided on then a Pfannenstiel incision (transverse suprapubic) is perfectly acceptable although a laparoscopic procedure is preferable. Laparoscopic surgery leaves fewer scars and has a faster recovery which is important as patients will be having multiple operations later. We do not perform hysterectomy on its own but can refer patients to a gynaecologist who offers laparoscopically assisted vaginal hysterectomy. It is possible to have a laparoscopic hysterectomy after having had a radial artery phalloplasty but it is easier if it is done before we connect up the neourethra (new urine tube) to the bladder.
    [Show full text]
  • Skeletal System? Skeletal System Chapters 6 & 7 Skeletal System = Bones, Joints, Cartilages, Ligaments
    Warm-Up Activity • Fill in the names of the bones in the skeleton diagram. Warm-Up 1. What are the 4 types of bones? Give an example of each. 2. Give 3 ways you can tell a female skeleton from a male skeleton. 3. What hormones are involved in the skeletal system? Skeletal System Chapters 6 & 7 Skeletal System = bones, joints, cartilages, ligaments • Axial skeleton: long axis (skull, vertebral column, rib cage) • Appendicular skeleton: limbs and girdles Appendicular Axial Skeleton Skeleton • Cranium (skull) • Clavicle (collarbone) • Mandible (jaw) • Scapula (shoulder blade) • Vertebral column (spine) • Coxal (pelvic girdle) ▫ Cervical vertebrae • Humerus (arm) ▫ Thoracic vertebrae • Radius, ulna (forearm) ▫ Lumbar vertebrae • Carpals (wrist) • Metacarpals (hand) ▫ Sacrum • Phalanges (fingers, toes) ▫ Coccyx • Femur (thigh) • Sternum (breastbone) • Tibia, fibula (leg) • Ribs • Tarsal, metatarsals (foot) • Calcaneus (heel) • Patella (knee) Functions of the Bones • Support body and cradle soft organs • Protect vital organs • Movement: muscles move bones • Storage of minerals (calcium, phosphorus) & growth factors • Blood cell formation in bone marrow • Triglyceride (fat) storage Classification of Bones 1. Long bones ▫ Longer than they are wide (eg. femur, metacarpels) 2. Short bones ▫ Cube-shaped bones (eg. wrist and ankle) ▫ Sesamoid bones (within tendons – eg. patella) 3. Flat bones ▫ Thin, flat, slightly curved (eg. sternum, skull) 4. Irregular bones ▫ Complicated shapes (eg. vertebrae, hips) Figure 6.2 • Adult = 206 bones • Types of bone
    [Show full text]