The passage by which urine is discharged from the bladder is called the urethra. It is lined with mucous membrane throughout, and its narrowest part is its external orifice, or meatus. In the male the urethra is about 8 inches long and consists of three portions, which are continuous, however. The first, or prostatic portion, begins at the neck of the bladder and traverses the prostate gland. Opening on its floor are the prostatic ducts, by which prostatic secretion is discharged, and the ejaculatory ducts, by which semen is discharged.
The second, or membranous, portion lies between the layers of the triangular ligament. It is very short, and except for the meatus is the narrowest part of the tube. The third portion is called the cavernous or spongy portion and traverses the corpus spongiosum of the penis. Opening into it are ducts of various glands and there are also recesses, or lacunae, opening off it. If infection invades the urethra it is apt to lodge in these ducts and lacunae, and hence the difficulty often met with in overcoming the infection.
From developmental defects the meatus may be found to open on the upper or on the lower surface of the penis. In the former event the condition is described as epispadias, and in the latter hypospadias.
By kicks or by falling astride on a hard object the urethra may be ruptured and the urine may flow through the opening into the surrounding tissues and perhaps further afield. This is called extravasation of urine. The accident may also be followed by a stricture, or narrowing, of the tubes, from the contraction of scar tissue.
Inflammation of the urethra, or urethritis, is usually caused by gonorrhea (q.v.) and frequently is followed by stricture. When it has this origin a stricture occurs in the cavernous portion of the urethra. It causes difficulty in passing water and the stream becomes smaller, sometimes it is forked or has a spiral form. If congestion of the lining of the urethra occurs, as after an alcoholic bout or from chill, there may be complete stoppage of the urine.
When a stricture has existed for some time dilatation and hypertrophy of the bladder occur and the effects of the obstruction may even extend to the ureters and kidneys. Occasionally the urethra becomes blocked by a stone, or calculus, or by a foreign body, either of which may have to be cut out.
A stricture should be dilated periodically with a gum-elastic or metal bougie. Sometimes it is necessary to divide the stricture either by cutting from the inside, internal urethrotomy, or from the outside, external urethrotomy. An examination of the lining of the tube can be made by means of an instrument called the urethroscope. In the female the urethra is about 11/2 inches long, and is wider and more dilatable than it is in the male. A small red swelling about the size of a pea, is sometimes found at the meatus, and is known as a urethral caruncle. It tends to cause slight bleeding but may be painless, though in some instances it causes a burning pain when the urine is passed and is very tender. If painless it is best left alone, otherwise it can be cut out or destroyed by the use of a cautery. See: Bladder.. Gonorrhea.. Prostate..
Application and treatment:
Inflammation of the urethra cause by infection, gout, gonorrhea, ulceration, formation of calcareous matter in the urethral wall, disorder affecting membranes and prostatic parts of the urethra, mild urethritis that sometimes follows chemical irrigation used to prevent venereal infections.
There may be intense itching (pruritus) and pain of the urethra in the female which conveys urine from the bladder and in the male conveying the seminal ejaculations.
It is made up of prostatic, membranous and spongy parts. Pain may be aggravated by urination. Use positive polarity for 10 minutes and negative for 5 minutes on the troubled area with 727, 787, and 880 hertz at very low output while switching polarity every 2 or 3 minutes.