Читать книгу Ridley's The Vulva - Группа авторов - Страница 50

Failure of the urogenital septum to reach the cloacal membrane leaves the urethra, vagina, and rectum converging into a single channel with a solitary opening on to the perineum.

Congenital abnormalities of the urethra are much less common in females than in males, but duplication of the urethra is a cause of incontinence. The accessory urethra usually arises from the trigone of the bladder and opens onto the anterior wall of the vagina. Mild forms of epispadias may occur in the female, giving rise to disturbance of bladder control and urinary incontinence. The urethral opening lies deep to the mons, and a bifid clitoris is seen [74]. Hypospadias in the female occurs in association with 46,XX DSD. In both epispadias and hypospadias, the female urethra is congenitally short [75]. Meatal stenosis is uncommon in females but can mimic bladder neck obstruction, and urethral cysts of the para‐urethral Skene’s glands can lead to recurrent urinary symptoms. A prolapse of the urethral mucosa occurs only in females [76]. An ectopic ureter may open into the urethra, and any of these urethral abnormalities may present with urinary incontinence, which leads to an irritant contact vulval dermatitis.