A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The mucous glands of the urethra are most numerous in the region of
the external meatus. Skene first described two glands that are worthy
of special mention. _Skene’s glands_ are two tubules, large enough to
admit a No. 1 probe of the French scale, that lie upon the floor of
the urethra immediately within the external meatus. They lie parallel
to the long axis of the urethra, and in length vary from ⅜ to ¾ of an
inch. They are placed beneath the mucous membrane, in the muscular
coat. The orifices of the glands are on the free surface of the mucosa,
immediately within the external meatus. In young women the orifices
are found about ⅛ of an inch above the plane of the external meatus.
If the external meatus be patulous, or if there be any prolapse or
inflammation of the mucous membrane of the urethra, the orifices of
Skene’s glands may be seen upon each side of the urethral orifice as
soon as the labia are separated. In gonorrhea their position is often
indicated by a small drop of pus exuding from the orifices. The upper
ends of the glands may terminate in a number of divisions.
=Urethritis.=--Urethritis is much less frequent in women than in
men. In the great majority of cases it is caused by gonorrhea. Aside
from microscopic examination, urethritis, acute or chronic, may be
considered one of the strongest evidences of gonorrheal infection that
we have.
Urethritis is also rarely caused by the exanthematous diseases,
irritation of concentrated urine, vaginal discharges, chemical
irritants, and traumatism.
_Symptoms._--The symptoms of urethritis in the acute stage of the
disease are frequent and painful urination. Burning and scalding
sensations are experienced along the course of the urethra during
urination. Occasionally a few drops of blood escape during or after
urination. As the disease progresses toward cure or passes into the
chronic stage, the intensity of these symptoms diminishes, and finally
they disappear.
Examination of the parts shows that the external meatus is red and
swollen. The swollen mucous membrane may bulge through the opening,
giving the appearance of prolapse. The orifices of Skene’s glands
may be conspicuous. If the woman have not recently urinated, a drop
of pus may appear at the meatus, or it may be brought into view by
vaginal pressure along the course of the urethra. Pressure upon the
urethra through the vagina causes pain. This is one of the best tests
of inflammation of this structure. The urethra may feel hypertrophied,
indurated, or cord-like to the touch. The urethral discharge should
always be examined microscopically for the gonococci.
In chronic urethritis the subjective symptoms are usually
absent--except, perhaps, frequency of urination. The diagnosis is made
by physical examination. If the woman has not urinated for several
hours, the examiner will be able to express, by vaginal pressure along
the course of the urethra, a drop of muco-purulent fluid resembling the
gleety discharge of the male.
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