Skene's Ducts Research Articles

Female Urethra Adenocarcinoma.

Female urethra adenocarcinoma (FUA) is a rare aggressive tumor that occurs in Skene ducts and glands. It is associated with a relatively poor prognosis. The aim of this review was to evaluate FUA in terms of epidemiology, risk factors, diagnosis, natural history of disease, modalities of treatment, and outcomes. These tumors are usually large masses, which typically spread through the lymphatic system. Patients present with vague symptoms similar to urinary tract infections. Cystourethroscopy permits visualization of the urethral tumor and allows biopsies to be performed to remove samples for histologic examination. Magnetic resonance imaging is recommended for tumor staging. Local, superficial, and distal urethral tumors may be treated by partial resection with preservation of the urethra. Radical urethrectomy with wide, comprehensive resection of the paraurethral tissues and anterior vaginal wall may offer superior local control for this disease. Advanced FUA and lymph node positivity are associated with poor prognosis for all survival outcomes (recurrence-free, cancer-specific, and overall survival). Multimodal therapy including surgery, chemotherapy, and radiotherapy is required in the modern management of FUA, although the specific role and combination of each treatment is less clearly determined. Wide resection after chemotherapy and/or radiotherapy is associated with the best local control, but it reduces quality of life.

Skenes gland cyst causing urinary retention

Introduction Skene`s gland also known as paraurethral glands are bilateral prostatic homologues glands. It was first discovered and described by Alexander Johnston Chalmers Skene in 1880. Paraurethral glands are located posterolaterally to the urethra. Embryologically derived from the urogenital sinus. Skene`s gland secretes a small amount of mucoid material which has a role in sexual stimulation and lubrication. The etiology of paraurethral cysts remains unknown. The obstruction of Skene's ducts as a result of infection or inflammation usually in response to skenitis, of which gonorrhea is the most common cause, or cystic degeneration of embryonic remnants of the paraurethral glands, have been assumed to be possible causes of paraurethral cysts. The distinguishing features of paraurethral cysts are the displacement of urethral meatus by the mass and a cyst containing milky fluid. Thus, we report a case of Skene's duct cyst in a female which presented with acute urinary retention secondary to the lateral displacement of meatus. Case description A previously healthy female presented to casualty with gradual onset of suprapubic pain, associating with a sudden onset of the inability to void for 6 hours. The patient was complaining of obstructive lower urinary tracts symptoms for 2 weeks. She had 3 uncomplicated normal full term vaginal deliveries with an unremarkable past medical or surgical history. Examination of the external genitalia revealed an ovoid, fluctuant, tender swelling located just inferior to pubic symphysis and completely displacing and stretching the external urethral meatus to the opposite side. Compression of the swelling did not result in fluid extravasation through the urethra. Vaginal patency was also verified. Insertion of 14 Fr foley’s catheter was managed with difficulty and drained 600cc clear urine. MRI showed normal kidneys, ureters and urinary bladder with a simple 2.1x2.7x3.3cm lower vaginal cyst with high protein/hemorrhagic content mostly a paraurethral gland duct cyst. Patient underwent examination under anesthesia, cysto-urethroscopy and skene’s duct cysts excision was done. Histopathology examination displayed the presence of benign cystic lesion lined by transitional and squamous epiltleium with focal surface ulceration; thereby confirming the diagnosis of paraurethral cyst. Foley’s catheter was removed after 5 days and she voided freely. Results and conclusions Skenes gland cyst should be listed in the differential diagnosis of a female patient who comes with an acute urinary retention.

Paraurethral cyst in two female newborns: Which therapy option?

Paraurethral cysts are rare in females, especially in the neonatal period. The aetiology of congenital paraurethral cysts is obstruction of Skene's ducts from para/periurethral glands. Paraurethral cysts may be totally asymptomatic, non-tender, soft, cystic, ovoid masses about 6-10 mm in size and yellowish in colour. These lesions may be discovered on either side of the urethral meatus during routine examination and most of these resolve spontaneously. This study reports two female newborns with paraurethral cysts treated with needle aspiration because of difficulty in excretion of urine on the first day of life. The second case needed another course of needle aspiration 1 month later. There is no consensus on the treatment because of the benign nature of the paraurethral cysts and the probability of spontaneous regression. Surgical alternatives include excision, marsupialization and needle aspiration. If a surgical approach is needed, e.g. because of difficulty in urination, needle aspiration should be used as the initial surgical intervention.

Book Review: The Human Female Prostate: From Vestigial Skene's Paraurethral Glands and Ducts to Woman's Functional Prostate.By Milan Zaviacic. Slovak Academic Press, Bratislava, Slovakia, 1999, 171 pp., $49.00

Book Review: The Human Female Prostate: From Vestigial Skene's Paraurethral Glands and Ducts to Woman's Functional Prostate.By Milan Zaviacic. Slovak Academic Press, Bratislava, Slovakia, 1999, 171 pp., $49.00

Weight, Size, Macroanatomy, and Histology of the Normal Prostate in the Adult Human Female: A Minireview

The female prostate (Skene's paraurethral glands and ducts) is situated in the wall of the female urethra and histologically possesses the same parts as the prostate of the male, ie, glands, ducts, and smooth muscle tissue. The ducts are more numerous than the glands and also exceed the number of the ducts in the male prostate, There is more smooth muscle (musculofibrous tissue) than in the male prostate The prostatic (paraurethral) ducts do not open into the vulva on the sides of the female urethra, but penetrate into the lumen of the urethra along its whole length. It is through the urethra that the female prostate discharges its contents.The mean weight of the prostate of the adult female is 5.2 gm and its size is 3.3 cm (length) × 1.9 cm (width) × 1 cm (height). 1f we the consider the meatal type, the most frequent type of the female prostate, then the weight would vary the range of 2.6 to 5.2 gm and represent roughly 1/10 to 114 of the mean weight (23.7 gm) of the prostate of the adult male.Contemporary research has presented the female prostate as a non-vestigial genitourinary organ with exocrine function (production of female prostatic fluid) and cellular equipment for neuroendocrine activity.Its function is re-flected by its particular structure, including the presence of secretory and basal cells in its prostatic glands, which cor-respond in detail to the secretory and basal cells of the prostate in the adult male, The female prostate can be affected by the same diseases as seen in the postpubertal male prostate, although the female prostate is less frequently affected than the male prostate. (The J Histotechnol 23:61, 2000)

The female prostate and prostate-specific antigen. Immunohistochemical localization, implications of this prostate marker in women and reasons for using the term "prostate" in the human female.

Prostate-specific antigen (PSA) is currently the most frequently used marker for the identification of normal and pathologically altered prostatic tissue in the male and female. Immunohistochemically PSA is expressed in the highly specialized apically-superficial layer of female and male secretory cells of the prostate gland, and as well as in uroepithelial cells at other sites of the urogenital tract of both sexes. Unique active moieties of cells of the female and the male prostate gland and in other parts of the urogenital tract are indicative of secretory and protective function of specialized prostatic and uroepithelial cells with strong immunological properties given by the presence of PSA. In clinical practice, PSA is a valuable marker for the diagnosis and monitoring of diseases of the male and the female prostate, especially carcinoma. In the female, similarly as in the male, the prostate (Skene's gland) is the principal source of PSA. The value of PSA in women increases in the pathological female prostate, e.g., carcinoma. Nevertheless, the total amount of PSA in the female is the sum of normal or pathological female prostate and non-prostatic female tissues production, e.g., of diseased female breast tissue. The expression of an antigen specific for the male prostate, i.e., PSA in female Skene's glands and ducts, and structural and functional parameters and diseases similar to that of the male prostate, have provided convincing evidence of the existence of a prostate in women and definitive preference of the term "prostate" over that of Skene's glands and ducts. The use of the term Skene's glands incorrectly implies that some other structure rather than prostate is involved, promoting the vestigial position of this female organ.

Metastasizing Adenocarcinoma of the Female Prostate (Skene's Paraurethral Glands): Histological and Immunohistochemical Prostate Markers Studies and First Ultrastructural Observation

The case of a 46-year-old women with well-differentiated adenocarcinoma of the female prostate (Skene's paraurethral glands and ducts) with inguinal metastases is reported. Besides adenocarcinomatous structures, also more solid parts of the tumor and anaplastic regions with dark cells were found on histological examination. Clear cancerous cells were typical for glandular and solid tumor parts. The cancerous cells showed distinct immunohistochemical positivity of prostate specific antigen (PSA) and prostate (specific) acid phosphatase [P(S)AcP]. These are the first published results of electron microscopic examination of formalin fixed tissue showing the ultrastructure of female prostate carcinoma, comparable to that of the male prostate carcinoma. In the female, similar to the male, the prostate carcinoma probably originates from the secretory (luminal) cells of the female prostatic glands.

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

PENICILLIN FOR THE TREATMENT OF CHEMORESISTANT GONORRHEA IN THE FEMALE

With the advent of the sulfonamides the eradication of gonorrhea from the human race seemed quite likely. The promise contained in the earlier reports for the treatment of gonorrhea with sulfonamides, however, has not been completely fulfilled. Moreover, the therapeutic results for the female have not been so good as for the male, because of vagaries in her anatomic makeup. The physiologic mucoid alkaline secretions of the cervix aid and abet the growth of the gonococcus; the anatomic arbor-like arrangement of the cervical glands conceal this micro-organism in protective depots for survival. Even against such odds the sulfonamides brought under control a very large number of women with acute and chronic gonorrhea. The exceptions were the females who harbored resistant strains or in whom, because of chronicity of long duration, the gonococcus had taken tenacious hold in the subepithelial layers of the mucosa lining Skene's ducts, Bartholin's glands, the endocervix

Prostatic Type of Paraurethral Glands Induced in Female Rats by Administration of Male Sex Hormone.*

Summary1. Skene's ducts in the female rat are usually rudimentary. Male hormone substance stimulates growth of these glands to a condition which resembles grossly and histologically the prostate of the male rat. 2. In the present series the incidence of these glands in 35 normal animals is 9.4%, in 13 oestrone-injected animals 0%, in 48 male hormone-injected animals 58.3%. 3. The state of Skene's ducts may be utilized as an indicator of the presence of male hormone. 4. In view of the growth response to male but not to female hormones, the occasional finding of Skene's ducts in an uninjected female rat suggests the presence of male hormone in the normal female. 5. The growth response of the female prostatic glands to the male hormone is further evidence of the masculinizing effect of male hormone substance of the female animal.

The office use of the electric cautery in gynecology

It is felt that the electric cautery offers a most satisfactory method of treating the milder types of cervical laceration and erosion in the office. In the more severe types, while the results are not so uniform, it is worthy of a trial before resorting to operation, especially if the woman be in the child-bearing period. It is probably the treatment of choice in chronic gonorrheal endocervicitis, gonorrheal infection of Skene's ducts, and the office treatment of urethral caruncle. The procedure is apparently harmless and so far as could be ascertained from this series without troublesome sequelae.