. The Principles and practice of gynecology : for students and practitioners. e vulva and anus are : Atresia. Persistent cloaca. Hypospadias. Epispadias. Infantile of the Urethra, Vagina, and Anus.—The cloaeal divi-sion by which the urethra, vasrina, and anus are opened and therebyprolonged to the external surface may fail to take place. This failure 508 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. will result in complete atresia of the vagina, urethra, and anus. Theperineal septum may be absent, as shown in Figure 239, or present,as shown in Figure 240. In the latter case the opening
. The Principles and practice of gynecology : for students and practitioners. e vulva and anus are : Atresia. Persistent cloaca. Hypospadias. Epispadias. Infantile of the Urethra, Vagina, and Anus.—The cloaeal divi-sion by which the urethra, vasrina, and anus are opened and therebyprolonged to the external surface may fail to take place. This failure 508 TUMORS, TUBAL PREGNANCY, MALFORMATIONS. will result in complete atresia of the vagina, urethra, and anus. Theperineal septum may be absent, as shown in Figure 239, or present,as shown in Figure 240. In the latter case the opening between therectum and the urogenital sinus will be closed. This condition ofcomplete atresia has been observed only in stillborn foetal monstrosi-ties. The bladder, urethra, and vagina—that is, the urogenital sinus—are apt to be distended with urine. Congenital atresia is not to be confounded with another form ofvulvar atresia in which the labia have become adherent from inflam-mation. This adhesion may occur before or after birth. The adhe- FlGXRE 241. FiGt-RE Figure 241.—BuiMiii. of a urethra. Authors operation. Congenital absence of and white dotted lines indicate area to be denuded in the construction of a newurethra. Figure 242.—Building of a urethra. Authors operation. Same as Figure 241. Area forconstruction of a new urethra denuded. Inner margins of denuded area being brought to-gether by continuous catgut sutures so as to unite those margins over the sound, which hasbeen introduced into the bladder and is held by the hand of an assistant. sion is generally incomplete, so that urine and menstrual fluid canescape. The condition has been designated superficial atresia of thevulva ; it may be remedied by separating the labia, either by divulsionor by cautious dissection. Persistent Cloaca.—In this anomaly the anus practically opensdirectly into the vestibule ; there is no perineum. The anomaly is apersistence of the condition in Figure 236.
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