Paraurethral Ducts Research Articles

A New Method of Treatment of Inflammatory Lesions of the Female Urethra

The female urethra is the homologue of the posterior urethra of the male. Vestigial remnants of the prostatic ducts and glands are part of the anatomy of the normal female urethra. These structures are predisposed to infection, both acute and chronic. A simple and successful method of treatment is aimed at complete eradication of the responsible primarily infected paraurethral ducts and glands and the dependent secondary pathologic changes of contiguous structures. Symptomatic relief, elimination of infection, and absence of recurrence in 206 patients have been impressive.

HISTOLOGICAL STUDY ON THE URETHRA IN THE WOMAN, ESPECIALLY ON ITS FOLD AND PARA-URETHRAL DUCT

Purpose of the study.In the urethra of the woman occurs unendurable pains of unknown origin, such as urodynia and feeling of strangury. In an attempt to solve the problems, the structure of the tissue is found to be so complicated that a considerable amount of the pains might be originated from the anatomical and histological structure. That is, the short urethra in the woman shows a variety in its strusture according to localization, especially having a number of so-called para-urethral ducts or folds in its anterior portion: this state is rather more complicated than that of the man. The present study is performed to clarify these unanswered problems.MethodThe total urethra was removed from cafuistic corpse of adolescent and adult women taking care of not hurting the original form, embedded into paraffin and sectioned in three directions. 1. Transverse section, 2. Sagittial section, 3. Horizontal section. After many kinds of stainings were applied to these sections, details of the histological structure of the urethra in the woman were observed together with the informations of mucous epithelium of the urethral cavity, the fold formation, and the number, direction and morphology of the para-urethral ducts.Results1) Morphology of the urethral cavity and its variation. The urethra in the woman is comparatively broad. Usually it is in contracted condition, forming natural folds. Only at micturition it becomes nearly cylindrical, a.. The cavity appears longitudinal or polylongitudinal around the opening, but changes to be transverse at the posterior portion.b.. Near the part of 1-1.5cm away from the opening there are polymorphic contracted fold formations; of mushroomshape or crab-shape.c.. Near the part of 2-2.5cm away the cavity takes a shape of butterfly in many cases.d.. Near the part of 2.5-3cm away it becomes like an upperly prominent semilune or a straight line.e.. At the inner part than 3cm away it is of an irregular form with a little larger interspace, becoming so-called neck of the urinary bladder and reaches the bladder. At the same time, according to the examination of the horizontal section, it is found that the urethra is broad at the lower wall and prominent at the upper part.2) Para-urethral ducta.. Around the opening there are so-called Skene's duct and similar ducts. Many case offer a number of large and small ducts at the margins of th external lip with the depression of mucous membrane. Near the part of 0.5cm away from the opening there exhibit also many ducts.b.. Near the part of 1-1.5cm away, the urethra takes shapes of irregularly transverse form, and deep fold formation like a crab or several butterflies. Surrounding this contricted urethra, large and small duct cavities occur at least more than ten, usually more than thirty. If all of them, adding small branches at the end are altogether calculated, the number may be several decades or countless.c.. Near the part of 2cm away, the urethra becomes in most cases of a butterfly-shape, consequently having a deep fold formation, while the duct number decreases suddenly into a few or even undetectable in some cases.d.. Near the part of 2.5-3cm away, the urethra becomes semilunar or of upperly prominent straight line. Most cases contain a few ducts, which occur especially at right and left sides of the urethra in usual cases.e.. At the part of more than 3.5cm away, as the urethra approaches to the inner meatus urinarius and the urinary bladder, so the urethral cavity exhibits an enlargement or lenticular form.The ducts are few or not visible in some cases.3) The fold formation in the urethra.There is the fold formation in the urethra. The most remarkable and deepest localization appears near the part of 1-1.5cm or 2cm away from the opening: the contracted part of the irregular petal-shape, the parts of the crab-shape and butterfly-shape; the both sides of the straight line part at middl

慢性淋菌性尿道炎 (化学療法後) に於ける組織内淋菌の研究

Gonorrhea appears to have been exterminated because of the advances in so-called chemotherapy, or has been removed from the category of disease classed as non-amenable to ready treatment. However, this disease is actually by no means a condition easy to treat, since unexpected cases of chronicity and remission are fairly numerous, often presenting much difficulty from the investigative standpoint. Furthermore, the unscupulous application of therapy without reorganizing its true nature makes the demonstration of the causative microorganisms difficult and confuses its differentiation from other types of urethritis. It is to be added that in our clinic the cases of gonorrhea still occupies the first place among all outpatients.For many years past we have been engaged in clinical and pathological studies of gonorrhea, and the results of pathologic findings in acute, chronic and atypical cases of the disease in both men and women have accumulated to a considerable dimension. Nevertheless, the work on the investigation of gonococci in the tissue lags still behind because of the difficulty attending their demonstration, and we have succeeded in obtaining real results only during the past 7-8 years. This situation, which is common to all investigators both here and abroad, is explainable chiefly by the difficulty in obtaining satisfactory staining of gonococci in the tissue. However. Hayashi (1954) has succeeded in obtaining satisfactory statning of the causative microorganism in the tissue of acute gonococcic urethritis of men, while Tabayshi (1959) in the tissue of cervical gland gonorrhea in women, both to the extent of discuss gonorrhea on the basis of directly demonstrable gonococci, which we have in the past studied only on the basis of histopathology. Despite these results, it is still exceedingly difficult to demonstrate the gonococci in the tissues of chronic and recurring types of the disease, which represent the most important cases of infection by this microorganism. Some 30-40 years ago, Kawazoe (1916) and Tabayashi (1928) demonstrated the organism in only a small percentages of many instances. Likewise, Arai and Watanabe (1930), Kusaka (1937) and others have reinvestigated this problem but were successful only in a few cases. One of the most confusing aspect of the problem related to the demonstration of gonococci in tissues is the presence of various non-bacterial granules, which is at present being gradually clarified. These granules can be differentiated by staining, thus affording little chance for diagnostic errors. The author has undertaken investigations on the gonococci in the tissues of most difficult cases of chronic and recurrent gonorrhea.The materials used for investigation consisted of 124 instances. Of these tissues those judged to present inflammatory findings of “+” upon histopathologic grounds were excepted, leaving only 80 cases with “_??_” findings. Portions of the urethra and of paraurethral duct were excised under the guidance of Sato's urethroscope, after having confirmed that the patients had been treated previously with either penicillin or some other chemotherapeutic agents.With reference to the methods of staining used, only the following six may be mentioned, since the results of staining by 12 varieties of stain had already been reported from this laboratory. The six staining methods here used are: Schmorl stain, Polychrome methylene blue, Gram Stain, Thionine stain, Unna-Pappenheim stain and Pappenheim's panchrome stain. Since the tissues present the pictures as influenced by stated amounts of chemotherapeutics previously applied to the patients, the number of gonococci demonstrable in the tissues is naturally reduced.The designation of the findings as to the number of gonococci descernible in the tissue has been made as “+” for a few, _??_ for 6-10 bacteria, and _??_ for 10 or more. In regard to the location where the organisms are found

Obstetrical-gynaecological eponyms: Alexander Skene and the paraurethral ducts.

Obstetrical-gynaecological eponyms: Alexander Skene and the paraurethral ducts.

Clinical significance of the paraurethral ducts and glands.

THE DETAILED anatomy of the paraurethral ducts and glands has been described in a previous contribution. 1 At that time it was shown by serial section wax model reconstructions that the normal female urethra is surrounded by a labyrinthine mass of paraurethral tubules, canaliculi and glandular elements. These structures are homologs of the prostate. 2 While they are vestigial in the female, they may at times give rise to pathologic entities of clinical significance. Historically, it is of interest to note that Regeneri de Graaf described 3 and illustrated (fig. 1) a glandlike structure about the female urethra which he called a female prostate. Alexander Skene 4 drew attention to two paraurethral ducts (Skene's ducts) and emphasized their importance in infections of the female genitalia. Skene's contribution was based on anatomic studies, and the illustrations (fig. 2) accompanying it are still the basis for most of the descriptions in modern

THE DETAILED ANATOMY OF THE PARAURETHRAL DUCTS IN THE ADULT HUMAN FEMALE

Abstract The material studied consisted of serial sections and wax model reconstructions of adult human female urethras. As a result of this study, a concept of the anatomy and histology of the paraurethral ducts is presented. It would appear that these ducts are not constant in number or location; that they not only form extensive ramifications throughout the tissues about the distal urethra, but that they may also extend to within a short distance of the bladder; and that the often numerous ducts terminate in tubular glands which are lined for the most part by columnar epithelium. This epithelium has some, although limited, secretory activity. The role which the paraurethral ducts may play in the etiology of lesions of the urethra and anterior vaginal wall is discussed.

The detailed anatomy of the paraurethral ducts in the adult human female

The material studied consisted of serial sections and wax model reconstructions of adult human female urethras. As a result of this study, a concept of the anatomy and histology of the paraurethral ducts is presented. It would appear that these ducts are not constant in number or location; that they not only form extensive ramifications throughout the tissues about the distal urethra, but that they may also extend to within a short distance of the bladder; and that the often numerous ducts terminate in tubular glands which are lined for the most part by columnar epithelium. This epithelium has some, although limited, secretory activity.The role which the paraurethral ducts may play in the etiology of lesions of the urethra and anterior vaginal wall is discussed.

The development of the periurethral glands in the human female

Serial sections have been prepared of the urethras and the lower urogenital area of female fetuses of 50 mm., 80 mm., 128 mm., and 224 mm. crown-rump lengths, and of six adult female urethras. Wax reconstructions of portions of these preparations have been made to illustrate certain points discussed. Anlagen of the periurethral glands were observed for the first time in a 50 mm. fetus. These anlagen appear as four small, solid buds arising from the ventral and lateral surfaces of the urethra above the müllerian tubercle. In the 80 mm. fetus urethral gland anlagen are evident as numerous buds, without branches, developing from the dorsal, ventral and lateral sides of the urethra above the müllerian tubercle. Branched glands are present in the 128 mm. fetus but at this stage, as in the younger embryos, only the area of the urethra above the müllerian tubercle gives rise to them. In the 224 mm. fetus the glandular arrangement is similar to that in the adult. At this stage the lower urethra reveals one diverticular-like pocket but no glandular structures are to be seen arising from the vestibule or the vaginal epithelium. In the adult urethras studied the orifices of all periurethral or para-urethral glands arise from the urethral mucosa. In none of the fetal or adult urethras examined in this series were any glandular structures observed arising from the urogenital sinus below Müller's tubercle, in the vaginal epithelium nor in the vestibule. These observations support Pallin's belief that the female periurethral glands are homologous with only that portion of the male prostate arising cephalad to the urogenital sinus. That this is for the most part true is evident from the material presented here-with. However, the classical work of Wyatt and of Johnson, who found occasional glands arising from the urogenital sinus below the müllerian tubercle make an attempt at correlation of these divergent findings necessary. Several explanations are possible: The most logical would seem to be that occasional small glands in the lower portion of the urethra are carried downward on the lips of the somewhat trumpet-shaped opening of the urethra into the upper end of the urogenital sinus. As a result, the indistinct union of the urethra and the urogenital sinus makes it appear that these periurethral glands are of sinus origin. It is also possible that occasional small true sinus glands are present in the female but that they are infrequent in number and not present in all individuals. Several small, straight, solid tube-like buds were noted in the 80 mm. fetus arising from the lower walls of the urogenital sinus. These were considered anlagen of Littre's glands which are profuse in the distal male urethra. It would appear from the material studied that the larger para-urethral ducts and glands (Skene's) arise from anlagen above the müllerian tubercle; that they are similar to the other periurethral glands in origin and structure; and, that they, like the periurethral glands, are homologues of that portion of the male prostate which develops above the union of the mesonephric ducts with the urogenital sinus.