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
Sometimes it is found that the suppuration persists in Skene’s glands.
A small drop of pus may be found exuding from the orifice of the gland
after the rest of the urethra has been restored to a healthy condition.
In such a case the gland should be split up on the urethral surface by
introducing into it one blade of a fine scissors, and the tract should
be carefully wiped out with pure carbolic acid or a strong solution of
nitrate of silver.
In every case of urethritis of gonorrheal origin it is of the greatest
importance that every trace of the disease should be eradicated before
the patient gives up treatment. There is always danger of infection
extending to the upper parts of the genital tract.
=Stricture of the Urethra.=--Stricture of the urethra in the woman,
unlike the similar condition in the male, is very rare. It is caused
by gonorrhea, injury at childbirth or other traumatism, and caustic
applications. The stricture may exist at any part of the urethral
canal. The form most usually seen is that which occurs at the external
meatus, and is caused by the removal of abnormal growths with caustic
or with the knife.
The _symptoms_ of urethral stricture in women are much less marked than
those in men. There is frequent and difficult urination. Occasionally
there is incontinence or partial retention of urine.
If the stricture exist at the external meatus, it may be readily seen
and its dimensions determined. If it exist in the upper portion of the
urethral canal, it may sometimes be felt by palpation along the course
of the urethra through the vagina, the position of the stricture being
indicated by local thickening and induration. Its location may also be
determined, as in man, by the use of the bulbous bougie or sound.
_Treatment._--When the stricture is situated at the external meatus,
it may be divided with the knife or forcibly stretched. When it is
situated in the upper portion of the urethra, it is best treated by
forcible dilatation.
[Illustration: FIG. 189.--Female urethral sound.]
The small uterine dilator is the most convenient instrument to use.
The dilatation should not extend beyond half an inch, for fear of
injuring the urethral walls or producing incontinence. In order to
prevent contraction, it is advisable to pass the large urethral sound
(10 millimeters) at intervals of one or two days after this operation,
until the patency of the urethra is ensured.
In some cases the continual subsequent use of the sound is necessary,
as in stricture in the male. The woman may be readily taught the use of
the instrument herself.
=Prolapse of the Mucous Membrane of the Urethra.=--Prolapse of the
urethral mucous membrane is of unusual occurrence. Prolapse may be
limited to part of the circumference of the meatus, or it may extend
around the whole canal. The condition is usually found in weak,
debilitated women. It may occur during childhood.
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