For skin!

Funny urology story of the day:

I called up a patient's mother today to make sure that she brought his X-rays for his surgery. W was scheduled to have an injection into his bladder to help repair a faulty valve mechanism between his bladder and his ureter, the tube that goes up to his kidneys. This involves the use of a cystoscope, a peculiar torture device unique to urologists (question, if you torture someone under anaesthesia, is it still considered torture?). Anyway, it's a long thin telescope that you put into someone's bladder through the urethra.

W's mom was very apologetic when she asked her question. I tried to place her accent. Greek? Russian?

"I know this must seem velly silly, but I must ask. This procedure - you do it through his organ?"

"You mean his penis? Yes, we do insert the scope in through his penis into his bladder to do the injection."

"Oh, and this procedure, it will not affect his organ, will it?"

"No, ma'am - it should not affect his organ at all."

This aside, it was a good day! Those of you who are squeamish should not proceed to the details. So, at the risk of causing severe nausea in those endowed with a Y chromosome, I proudly announce that today I...

...skinned my first penis!

And no, urologist do not go home every evening and place little notches on their bedposts when they do this, but it is exciting nevertheless, because many people do not get to skin baby penises until very late in their residency.

Okay, so the technical term is to "deglove" the penis in the process of repairing a penile torsion, or twist. But that's all jargon for peeling off the skin around the corporal bodies that comprise the erectile tissue of the penis.

I mean, we sewed it back together again, so it's not that bad (it should heal up just like new). But it was extremely challenging. The average baby penis is about two and a half centimeters long, with skin about the thickness of a wonton wrapper (indeed, that's what my attending told me to practice my sewing and knot tying on). The skin is attached to the underlying erectile tissue by a tough, adherent mass of filmy tissues that supply it blood. The trick to skinning this cat is to cut the filmy tissues while avoiding the fine microscopic network of vessels, at the same time making sure that you don't cut into either the skin or the (somewaht important, I would say) erectile bodies underneath.

Basically, you have to find the zone, the sweet spot (the P-spot?). And when you do, it's the difference between gnawing through bloodied and fibrous tissue, and having the foreskin fall away in slick bluish white curtains of perfectly bloodless tissue. It's like buttah. And it's strangely exhilarating, finding this place, this "plane" as we call it.

Simple people, simple pleasures, I guess.