Читать книгу Ridley's The Vulva - Группа авторов - Страница 68

The female urethra is about 4 cm long and runs from the bladder downwards and forwards, embedded in the anterior wall of the vagina behind the symphysis pubis. The length can vary, and in a large study of 927 Caucasian women, the length was increased in the obese but reduced in those with a history of vaginal delivery [25]. After passing through the pelvic floor and perineal membrane, it ends at the external urethral orifice. The urethra is fixed at its origin by the pubovesical ligaments, throughout its length by the anterior wall of the vagina, and as it enters the perineum by the urogenital diaphragm. The external urethral orifice lies in the midline of the vestibule between the vagina and the clitoris. The orifice is easily seen, and on occasions there may be bright red projections of prolapsed urethral mucosa herniating out. These urethral caruncles are most commonly seen in post‐menopausal women and are thought to be due to reduced oestrogen (Figure 2.10).

Figure 2.10 Urethral caruncle in a patient with lichen sclerosus.

Skene’s glands (paraurethral glands) are paired glands with their ducts opening on each side of the urethral orifice. Evidence suggests that they are analogous to the male prostate gland [26].