URETHRA. 



12G5 



Its nerves arise from the puclic and the hy- 

 pogastric plexus of the sympathetic. 



Prostate gland of the female. Has the fe- 

 male a prostate ? Outline, in his work on 

 " Diseases of the Bladder and Urethra," as- 

 signs a prostate to the female, which, accord- 

 ing to him, has a form like that of the male 

 prostate, and nearly a similar structure. He 

 says it surrounds the commencement of the 

 urethra. He further states it to be the size 

 of the prostate of a boy before the age of pu- 

 berty ; and rather regards it as existing in a 

 rudimentary form than as an organ possessing 

 any follictilar or glandular structure. He con- 

 siders it as of use in giving the urethra support, 

 and as affording a fixed point for the action of 

 some of the muscular fibres of the bladder. 



Guthrie quotes the authority of De Graaf, 

 " De Mulierum Organis," in support of his 

 opinion. " Sed ulterius, inquiret aliqitis, wide 

 illi dnctus sive lacuna; humorem ilium hauriant ? 

 priores like scilicet, quocirca colli orificium et 

 mcatus urinarii exitum conspiciuntur ex parasta- 

 tis mulierum sen potius crasso et membranoso 

 corpore circumcirca meatum urinarium existente 

 humorem suum accipiunt ; posteriores vero ex 

 nervoso-mcmbranosd colli uterini substantia liquo- 

 rem suum colligunt." 



De Graaf, however, refers to that mass of 

 follicles surrounding the meatus and com- 

 mencement of the urethra, rather than to any 

 special organ worthy of the designation of 

 prostate. Cowper also denominates the mass 

 of follicles surrounding the meatus as the 

 " corpus glandulosum." 



I confess that I have not been able to trace a 

 prostate in connection with the female urethra : 

 there is, however, generally found a firm mass 

 around the canal, which is much thicker at the 

 under part than at the upper, and to which I 

 believe Mr. Guthrie refers. It is certainly not 

 muscular; but it does not present evidences of 

 glandular structure; containing merely a large 

 quantity of areolar and elastic fibre. Accord- 

 ing to the notions of the homologies of the 

 male and female now prevalent, the prostate 

 should be represented in the female by a rudi- 

 mentary structure in connection with the 

 uterus rather than the urethra, inasmuch as it 

 is essentially a sexual organ, and developed in 

 the embryo from the protome tra. 



PATHOLOGY. The female urethra is 

 wanting where the entire uropoietic system 

 is absent, as also when the bladder is defi- 

 cient : it is also wanting in cases of ecrophy of 

 the female bladder, and in cloacal formation. 



In consequence of arrest of development, 

 it may terminate in the vagina, or may receive 

 the vagina or rectum at the posterior part. 



Sometimes the urethra is abnormally di- 

 lated, as a congenital malformation.* This is 

 rare : it is more frequently dilated after the 

 removal of calculi, &c., from the bladder. 

 Rare instances have been known in which the 

 act of copulation has been performed through 

 the urethra instead of the vagina. 



^ * Eokitansky's Pathological Anatomy, vol. ii., 

 Sydenham Society's edition. 



VOL. IV. 



Preternatural contractions of the urethra 

 sometimes occur from pressure of the displaced 

 uterus or the prolapsed vagina: they some- 

 times arise, as in the male, from inflammation, 

 and constitute true stricture of the canal : this 

 is exceedingly rare. 



The urethra deviates from its normal direc- 

 tion in prolapsus of the bladder and uterus ; 



it takes on more or less of a serpentine direc- 

 tion ; this distortion of the canal not unfre- 

 quently gives rise to retention of urine. As 

 the uterus enlarges during pregnancy the blad- 

 der is carried upwards, and, with it, the urethra 

 is slightly raised. 



The urethra may, however, be excessively 

 dilated without incontinence of urine, of 

 which an instance has come to my own know- 

 ledge. A woman of the town was admitted 

 into the London Hospital, in consequence of 

 retention of the menses : she had imperforate 

 hymen ; the urethra was enormously dilated, 

 and no doubt she had admitted sexual inter- 

 course through. She had no incontinence of 

 urine. 



Dr. Chamberlain also met with a case of 

 imperforate hymen, where the urethra ad- 

 mitted the forefinger.* Dr. Oldham has ob- 

 served the same in atresia vaginas, unattended 

 with incontinence of urine. 



The urethra suffers a partial or total in- 

 version, forming a tumour at the vulva, 

 attended with difficulty and pain in voiding 

 urine. 



M. Sernin mentions the case of a girl eleven 

 years of age, who experienced difficulty in 

 making water. He examined her after a vio- 

 lent attack, and found a cylindrical body, four 

 inches long, hanging from the vulva ; and 

 whenever she attempted to make water this 

 projection swelled up. It was removed with 

 success. It was presumed to be an inverted 

 urethra.-f- 



The female urethra is liable to injuries of 

 various characters : the most common are 

 simple contusions and lacerations, or it may 

 be divided partially or completely by cutting 

 instruments. The urethra frequently suffers 

 contusion with the neck of the bladder in 

 cases of protracted labour, from pressure of 

 the child's head against the pubis. Under these 

 circumstances sloughing often succeeds, and a 

 fistulous communication between the urethral 

 orifice of the bladder and vagina results, lead- 

 ing to incontinence of urine. 



Lacerations of the female urethra are very 

 uncommon, and require no particular observa- 

 tions ; a simple retention of the parts by suture 

 woidd be advisable to secure their re-union. 



Simple incisions of the urethra, as in the 

 operation of lithotomy, generally reunite suc- 

 cessfully : this, however, is not invariably the 

 result, and hence the occasional occurrence of 

 incontinence of urine. The urethra, although 

 extremely dilatable, is occasionally stretched 

 beyond its natural capacity, in the removal of 



* See also Portal, Ccurs d'Anat. He'd. vol. iii 

 p. 476. 

 t Kecul. Period, torn. xvii. p. 304. 



4 M 



