THE PATHOLOGY AND TREATMENT OF OBSTRUCTIONS AT THE VESICAL NECK IN WOMEN

Abstract

The pathology and treatment of obstructions at the vesical neck in women and the inflammatory conditions that lead up to them have received scant attention in the American literature. Two years ago I was able to collect and present thirty-six cases. I showed that the development of hesitation, difficulty in starting micturition, slowness of the stream, irritation, pain, hematuria and the presence of more or less complete retention of urine are quite similar to those conditions in men. On cystoscopic examination the mucosa of the urethra and adjacent portion of the trigon is inflamed, often edematous or even papillomatous. The trigon sometimes hypertrophies as a result of the obstruction. The bladder becomes trabeculated and sometimes cellular from back pressure and increased activity of the detrusors. Impairment of renal function may result from residual urine and back pressure effects on the ureteral orifices and the consequent dilatation of the ureters, pelves