THE MALE URETHRA. 



1005 



obstruction to the flow of urine. Under these circumstances the bundles of which the muscular 

 coat consists become much increased in size, and, interlacing in all directions, give rise to what 

 is known as the fasciculated bladder. Between these bundles of muscular fibres the mucous 

 membrane may bulge out, forming sacculi, constituting the sacculated bladder, and in these 

 little pouches phosphatic concretions may collect, forming encysted calculi. The mucous mem- 

 brane is very loose and lax, except over the trigone, to allow of the distention of the viscus. 



Various forms of tumors have been found springing from the wall of the bladder. The 

 innocent tumors are the papilloma and the mucous polypus, arising from the mucous membrane ; 

 the fibrous, from the submucous tissue ; and the myoma, originating in the muscular tissue ; 

 and, very rarely, dermoid tumors, the exact origin of which it is difficult to explain. Of the 

 malignant tumors, epithelioma is the most common, but sarcomata are occasionally found in the 

 bladder of children. 



Puncture of the bladder may be performed either above the pubes or through the rectum, 

 in both cases without wounding the peritoneum. The former plan is generally to be preferred, 

 since in puncture by the rectum a permanent fistula may be left from abscess forming between 

 the rectum and the bladder ; or pelvic cellulitis may be set up ; moreover, it is exceedingly 

 inconvenient to keep a cannula in the rectum. In some cases in performing this operation the 

 recto-vesical pouch of peritoneum has been wounded, inducing fatal peritonitis. The operation, 

 therefore, has been almost completely abandoned. 



THE MALE URETHRA. 



The urethra in the male extends from the neck of the bladder to the meatus 

 urinarius at the end of the penis. It presents a double curve in the flaccid state 

 of the penis (Fig. 557), but in the erect state of this organ it forms only a single 

 curve, the concavity of which is directed up- 

 ward. Its length varies from eight to nine 

 inches ; and it is divided into three portions, 

 the prostatic, membranous, and spongy, the 

 structure and relations of which are essentially 

 different. Except during the passage of the 

 urine or semen, the urethra is a more trans- Cowper's gland.^ 

 verse cleft or slit, with its upper and under 

 surfaces in contact. At the meatus urinarius 

 the slit is vertical, and in the prostatic portion 

 somewhat arched. 



The Prostatic Portion is the widest and 

 most dilatable part of the canal. It passes 

 through the prostate gland, from its hase to 

 the apex, lying nearer its anterior than its 

 posterior surface. It is about an inch and a 

 quarter in length ; the form of the canal is 

 spindle-shaped, being wider in the middle than 

 at either extremity, and narrowest below, where 

 it joins the membranous portion. A transverse 

 section of the canal as it lies in the prostate 

 is horse-shoe in shape, the convexity being 

 directed forward (Fig. 563), since the direction 

 of the canal is nearly vertical. 



Upon the floor of the canal is a narrow 

 longitudinal ridge, the verumontanum, or caput 

 gallinaginis, formed by an elevation of the 

 mucous membrane and its subjacent tissue. 

 It is eight or nine lines in length, and a line 

 and a half in height ; and contains, according 

 to Kobelt, muscular and erectile tissues. When 

 distended, it may serve to prevent the passage 

 of the semen backward into the bladder. On 

 each side of the verumontanum < is a slightly 

 depressed fossa, the prostatic sinus, the floor 

 of which is perforated by numerous apertures, the orifices of the prostahc duct 

 from the lateral lobes of the gland ; the ducts of the middle lobe open behind the 



