A practical treatise on the diseases, injuries and malformations of the urinary bladder, the prostate gland, and the urethra / by Samuel D. Gross.

Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases, injuries and malformations of the urinary bladder, the prostate gland, and the urethra / by Samuel D. Gross. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    the other was situated at the lowermost ])art of the navicular fossa, iiearl^^ at tlie base of the freimm. The latter was quite capacious, and afforded vent both to the urine and the semen; the rest M^ere very small and contracted, and permitted the urine to pass onl}^ Mdieii this fluid was ejected with unusual force. I have met with several instances of double meatus, in none of which, however, more than one opened into the urethra, the other ending in a blind pouch. Such a condition generally represents the lightest grade of hypospadias, the normal opening being denoted by a gutter two or three lines deep. The orifice is occasionally occluded, either partially or com- pletel}L In the former case, the narrowing may he effected by an unusually small opening with inverted edges; in the latter, by an extension of the mucous membrane, or of the mucous membrane and a small quantity of the proper structure of the gland. A similar arrangement occasionally exists in the urethra of the female. A very rare and interesting case of membranous closure of this tube, associated with patency of the urachus, was observed by Berthelemi Cabrol, of Montpellier, in a girl eighteen years old. The urine had escaped, ever since birth, at the um- bilicus, which projected about four inches from the abdomen, and exhaled an intolerable stench. A very similar case is recorded by Pitha. 2. The urethra may be absent. Of this occurrence the best marked example is seen in that variety of exstrophy of the bladder in which the urine and semen are discharged above the pubes. This species of malformation is exceedingly rare, and is necessarily accompanied with impotence. The canal in question is sometimes preternaturally narrow, or completely occluded. The defect may involve the entire canal, or it may be limited to a particular portion. Jules Cloquet met with an instance in a new-born child, in which the contraction existed at the middle of the urethra, and was upwards of an inch in length. Com- plete atresia, without deformity of the penis, can, however, scarcely exist, and a careful examination will disclose a very minute orifice somewhere along the course of the inferior wall of the urethra, and behind the corona of the gland. Hence, these cases must be regarded simply as exanqfles of imperfora-