CHAPTER III. 



DISEASES OF THE URETHRA. 



Examination. —The urethra may be examined in two 

 ways : 



(a) In the male it is possible to palpate from without 

 along its course until it passes over the ischial arch; the part 

 within the pelvis may be palpated through the rectum. 

 Palpation will reveal sensitiveness in cases of urethritis a'nd 

 calculi lodged at some point along its course. There are 

 three parts of the urethra in which calculi are most apt 

 to lodge: At the neck of the bladder; where the prostate 

 glands practically surround it, and at the posterior end of 

 the bone of the penis. At these points, owing to the struc- 

 ture of the urethra and adjacent parts, any foreign material 

 passed from the bladder is most apt to become lodged. In 

 the female the urethra can be palpated through the vagina. 

 In the female, the urethra, as a rule, is free from foreign 

 material, because any substance of this kind small enough 

 to pass from the bladder into the urethra, will be forced out 

 with the urine. 



(b) The passage of the catheter or sound is a valuable 

 means of determining the sensitiveness of the mucous mem- 

 brane, the presence of calculi or other foreign material, or 

 strictures at different points along the course of the urethra. 

 Care should be taken in inserting the catheter not to injure 

 the urethral mucosa; also one should not mistake the normal 

 narrowing of the lumen of the urethra for strictures, etc. 



CONGENITAL MALFORMATIONS. 



Occlusion of the Urethra. 



Occlusion of the urethra is occasionally found in both the 

 male and female. Sometimes an opening exists in some other 

 portion of the urethra through which the urine is discharged. 



