. The Principles and practice of gynecology : for students and practitioners. -charges of gonorrhoea, senile endometritis, and vulvovaginitis, arethe commonly assigned causes. 1 M. Lange. Zeitschrift fiir Geburtshiilfe und Gynakologle. 470 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. Diagnosis.—This growth is of frequent occurrence, and is a small,soft, red, friable, hemorrhagic mass situated usually at the marginand on the vaginal side of the meatus urinarius. It may, however, beanywhere in the urethra. There is usually a previous history ofpelvic disease. There often is associated great sensitive


. The Principles and practice of gynecology : for students and practitioners. -charges of gonorrhoea, senile endometritis, and vulvovaginitis, arethe commonly assigned causes. 1 M. Lange. Zeitschrift fiir Geburtshiilfe und Gynakologle. 470 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. Diagnosis.—This growth is of frequent occurrence, and is a small,soft, red, friable, hemorrhagic mass situated usually at the marginand on the vaginal side of the meatus urinarius. It may, however, beanywhere in the urethra. There is usually a previous history ofpelvic disease. There often is associated great sensitiveness or ex-treme pain on urination ; but, according to Lange, this pain is due notso much to the growth itself as to the complications. The Differential Diagnosis from Skenes glands has been givenin Chapter XXIV. The growths may be differentiated from othertumors in the sama region by the constant finding of urethral glandsin the caruncle, although the structure of the glands is modified fre-quently by hemorrhage, round-cell infiltration, and prolapse of the FiauR£ Carcinomff in the bladder. urethra so that the free surface of the caruncle no longer bearscylindrical nor transitional epithelium. Treatment.—The treatment is excision with the scissors under thebase of the growth, and when practical union of the wound by may require dilatation of the urethra, as described in Chap-ter III., or Urethrotomy, as described in Chapter XXIV. Theactual cautery, though commonly used, is objectionable on account ofunreliability and because of its destructive and cicatricial effects. Thefrequency with which these growths return after surgical removal isdue undoubtedly to the failure of operators to treat successfully thecausative complications. Warts, Mucous Polypi, Carcinoma, and Sarcoma follow thesame principles of pathology, diagnosis, prognosis, and treatment aswhen they occur in the vulva. TUMORS OF THE All TUMORS OF THE BLADDER. Tumors ()rii;iiuitii


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