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Examination of the Urethra

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EXAMINATION OF THE URETHRA.

After completing the examination of the bladder and ureters, the urethra is examined throughout its whole extent, beginning with the internal orifice, and proceeding out to the external one, as the speculum is slowly withdrawn.

As soon as the speculum leaves the lumen of the bladder, the in ternal urethral orifice is seen projecting over the edge on all sides, in the form of a fine ring. Upon withdrawing the speculum a little farther the ring increases in breadth, contracting, as the speculum continues to be withdrawn, in a circular, oval, or trapezoidal form. Just as the lumen is about to disappear by the meeting of the walls on all sides, it looks like a small pinhole, or a little oval, 2 or 3 mm. in diameter; it is not a slit as stated by so many writers.

Throughout the length of the urethra, the funnel-shaped figure formed by the mucous folds converging from the edges of the specu lum to the centre of the canal is made up of a number of plicaa, 1 or 2 mm. in diameter, usually showing distinct vessels running parallel

with the canal.

The color is a deep rose or red, not as intense as in the male. At both extremities, within a centimetre of the internal and external os, groups of glands and tits are seen as points or little yellowish spots on the mucosa. They are found more abundantly on the vaginal side to the right or left of the median line. These are the crypts or pits and the acinous glands.

Just as the speculum is about to escape entirely from the urethra, the mucous surface becomes pale and the orifices of Skene's tubules come into view, appearing as darkish points about 1 mm. in diameter.