ANOMALIES OF DEVELOPMENT OF THE PROSTATE.
Congenital anomalies of the prostate are rare, at least from a clini cal standpoint. It is probable that they are more frequent than is generally supposed, but from the fact that they are not likely per se to prove of pathological importance, they are not often brought to our attention. Defective development incidental to extreme degrees of hypospadias and epispadias are occasionally seen. In these ex treme cases the prostate is usually distinguished by its absence. The anomaly requires no consideration excepting such as is incidental to the deformity of which it is a part. Defective development of the prostate is quite frequent and is associated as a rule with defective development of the sexual apparatus as a whole. The prostate is apt to be wanting in cryptorchids. In certain cases of sexual per verts, and in individuals who are imperfectly developed and imper fectly differentiated from a sexual standpoint, the prostate remains undeveloped, this lack of development being both muscular and glandular, as might be expected from the rudimentary condition of the other portions of the sexual apparatus. The inhibition of pros tatic growth is due not to a failure of the individual to perform his sexual functions in a normal manner, but to an inhibition of develop ment which may be more or less general, and which always involves all the component parts of the sexual apparatus.
That imperfect or exaggerated development of the prostate occurs alone is possible, but this is a question which for obvious reasons is extremely difficult of solution. It would seem that aberrations of development of a functionally very important structure of the pros tate, viz., the veru montanum, are possible. Independently of the
existence of infectious or inflammatory disease, cases of imperfect or exaggerated development of this structure probably occur. It would be difficult, however, to eliminate in such cases the effects of mastur bation and sexual excess. Stricture of the prostatic urethra is as serted by so excellent an authority as Thompson to be an unknown condition. The author has several specimens in which distinct bridles of an apparently congenital character are seen to be present in the anterior portion of the prostatic urethra. Some other speci mens in his possession show an abnormal narrowing of the prostatic urethra at its junction with the pars membranosa and a distinct lateral deviation of the canal. In several specimens the prostatic urethra, instead of tunnelling the centre of the apex of the prostate, diverges to such a distance from the median line that obstruction to the passage of instruments must almost of necessity have been experienced during ' the life of the patient, had such instrumentation become necessary. It will be readily understood that these conditions of abnormal nar rowing and deviation in all probability produced no disturbance, inasmuch as there were no evidences of disease of the 'mucous mem brane to be found. Should such a canal, however, become infected with gonorrhoea, a far different state of affairs would be instituted and considerable trouble might result from the congenital conditions present. The author is inclined to believe that such congenital de formities of the prostatic urethra may be responsible for the difficulty experienced in instrumentation in some cases of urethral disease.