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Treatise on gynaecology : medical and surgical . r incomplete, the rectum, the bladder, and the genitalcanal are separated or in communication (Fig. 139, 1, 2). Infantswith this malformation are seldom viable. The urethra being absentor imperforate, the bladder and the genital canal are enormously dis-tended with urine. The absence of the cloacal septum is at times observed alone, the MALFOEMA-TIONS OF THE VULVA, AND PIERMAPIIR0DI8M, 439 uro-genital sinus being open and communicating freely with therectum, which does not reach the anus but appears to end in thevagina; this form is called ano-v
Treatise on gynaecology : medical and surgical . r incomplete, the rectum, the bladder, and the genitalcanal are separated or in communication (Fig. 139, 1, 2). Infantswith this malformation are seldom viable. The urethra being absentor imperforate, the bladder and the genital canal are enormously dis-tended with urine. The absence of the cloacal septum is at times observed alone, the MALFOEMA-TIONS OF THE VULVA, AND PIERMAPIIR0DI8M, 439 uro-genital sinus being open and communicating freely with therectum, which does not reach the anus but appears to end in thevagina; this form is called ano-vulvar, vestibular, and ano-vaginalatresia (atresia ani vestibularis, sen ani vaginalis,^ Fig. 138, 3). Inreality it is not into the vagina that the rectum opens, but into theuro-genital sinus, Avhich receives also the vagina, at times imperfectlyseparated from the rectum by a se]3tum, and the urethra. This ren-ders the homology difficult to establish, and the relations of the partshave been subordinated to their dimensions, which are altogether. Fig. 139.—Malformations of the External Genital Organs. Diagrammatic. (Schroder.) 1. Com-plete atresia of the vulva, r, Rectum ; g, genital canal ; b, bladder, communicating with both. 2. Com-plete atresia of the vulva ; r, rectum seijarated from the allantois ; b, bladder, and (/, genital canal, dis-tended with urine. 3. Atresia of vagina and anus, d, Perineum, incomplete ; b, bladder ; v, vagina, andT, rectum, open by a common cloaca. 4. Hypospadias in the female. First degree coincident with hyper-trophy of the clitoris, s. Persistent uro-genital sinus, to which succeeds the long vestibular canai ; u,urethra, and v, vagina, opening into the vestibular canal; c, hypertrophied clitoris. 5. Hypospadias inthe female, properly so called ; the allantois wholly transformed into a bladder which opens directly, with-out the intermediate urethra, into the urogenital sinus ; that is, into the vestibule. accessory. The malformation may be simj
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