-
Views
-
Cite
Cite
Sidney Glina, Hui Meng Tan, Ahmed I. El-Sakka, Ajay Nehra, Classic Citations: Further Experience with an Operation for the Cure of Certain Types of ImpotenceO.S. Lowsley, and A. Rueda, The Journal of Sexual Medicine, Volume 6, Issue 8, August 2009, Pages 2096–2101, https://doi.org/10.1111/j.1743-6109.2009.01387.x
Close - Share Icon Share
Extract
Lowsley and Rueda published in 1953 [1] a longer experience with an operation earlier described by Lowsley in 1935 [2]. The aim of the surgery was to reduce the outflow of corpus cavernosum by increasing the compression made by ischiocavernous and bulbocavernous muscles.
They stated that in animal experiments, Lowsley had confirmed an old theory that erection was “caused by stasis due to contraction of the ischiocavernous and bulbocavernous muscles”. By tightening those muscles on 16 dogs, he could produce priapism that had lasted for 6 months. On the other hand, the “complete excision of those muscles made erection impossible, even when the animal was submitted to sexual stimuli”.
The operation was done with the patient in “exaggerated” litothomy position and a midline perineal inverted Y incision was made; the corpus spongiosum, surrounded by bulbocavernous and bulbospongiosus muscle and both corpora cavernosa, surrounded by ischiocavernosus muscle were exposed [1].
A chromic ribbon gut was placed into the lateral edge of the bulbocavernous muscle, pulled across the belly of the muscle and passed through the other side. The ribbon was tied with “just sufficient strain to plicate the muscle and produce the exact amount of pressure to reinforce any contraction necessary to aid in producing an erection”. Normally three stitches were enough to tighten the whole muscle. A figure-of-eight ribbon gut suture was inserted into the ischiocavernosus muscle on each side, shortening the muscle by approximately 1 in.
