BULBOUS AND URETHRAL GLANDS

From Big Medical Encyclopedia

BULBOUS AND URETHRAL GLANDS [glandulae bulbourethrales (PNA, JNA, BNA); synonym: bulbouretralny glands, Cooper's glands] — the pair ferruterous body at men located at the blind end of a bulb of a penis near a webby part of an urethra. Are described in 1684 by the English surgeon Cooper — more correct W. Cowper.

Fig. 1. The diagrammatic representation of an arrangement of bulbous and urethral glands (are specified by shooters); back view: 1 — a bladder; 2 — a deferent duct; 3 — a seed bubble; 4 — a prostate.
Fig. 2. The diagrammatic representation of a sagittal cut of a basin through a bulbous part of an urethra: 1 — a webby part of an urethra; 2 — bulbous and urethral gland; 3 — a channel of bulbous and urethral gland.

L. - at. are a homolog of big glands of a threshold (bartolinovy glands) at women (see. Vulva ). Size they about a pea, yellowish-brown color. Muscle fibers of a deep cross muscle of a crotch (m. transversus perinei profundus) cover them and at the same time stratify ferruterous fabric so the last gets out of the shape and is macroscopically hardly noticeable. Both glands lie quite close from each other (fig. 1) and sometimes are connected among themselves by the bridge from muscle fibers forming an isthmus. Vyvodnoy Canal of bulbous and urethral gland (ductus gl. bulbourethralis) 5 — 6 cm long terminates in a shcheleobrazny opening in an urethra (fig. 2).

Along with these L. - at. also additional pieces of iron with blindly terminating channels are observed. The cosecreting epithelium covers not only final branchings of gland, but also a wall of an output channel. Walls as the main, and final tubules are covered by a single-layer cylindrical epithelium. On the blind end of gland final branches are located much more often; they larger also extend in the form of the ampoules representing storage for a secret of gland. Function L. - at. it is not found out. Apparently, at ejection of a seed from an urethra contents of L. - at. under the influence of reduction of smooth and cross-striped muscles it is brought out of an output channel and mixes up with an ejaculate.

Fig. 3. Diagrammatic representation of a manual research of bulbous and urethral glands: 1 — bulbous and urethral gland; 2 — an urethra; 3 — a prostate; 4 — a bladder; 5 — a rectum.

Research L. - at. carry out in position of the patient on spin. The area of a crotch is felt between the big and entered into a rectum index fingers (fig. 3). In the presence of consolidation determine its sizes, a consistence, a form, sensitivity, a spayaniye with skin. The inflamed gland is probed in the form of a pea, can sometimes be slightly more. Make massage of L for receiving a secret and its microscopy. - at. The urethra is washed out solution of Furacilin 1: 5000, the bladder is filled by 50 — 70 ml of isotonic solution of sodium chloride. Having groped L. - at., it is squeezed between big and index fingers several times, then the massing movements on a side surface of a bulb in the distal direction are made; the patient empties a bubble. In the first 20 — 25 ml of the produced liquid the secret of L contains. - at.

Pathology

inflammatory diseases of various genesis Most often meet. Retentsionny cysts and tumors meet seldom.

Cooperite — an inflammation of L. - at. — arising most often owing to transition of an infection from an urethra on an output channel in gland at gonorrheal and not gonorrheal uretrita. At acute gonorrhea N. A. Smirnov and I. F. Shishov observed cooperite in 12% of cases. Frequency of defeat of L. - at. at modern methods of treatment of gonorrhea decreased. A. I. Lopatin (1969) revealed cooperite as a complication of a mecotic urethritis in 13,3% of cases. Tuberculosis of L. - at. meets seldom.

Distinguish 4 forms of gonorrheal cooperite: catarral, follicular, parenchymatous and paracooperite — an inflammation of all parenchyma of gland with transition of process to surrounding cellulose. Upon transition of acute cooperite in hron, a stage there can be infiltrates and retentsionny cysts. Tubercular defeat of L. - at. sometimes leads to formation of abscess and a fistula of gland.

Cooperite more often happens unilateral, and process in most cases develops at the left. At a catarral and follicular form usually there are no complaints characteristic of an uncomplicated urethritis. Parenchymatous cooperite causes the crotch pain amplifying at the movement, sitting on a firm subject, defecation. More expressed frustration are observed at paracooperite when there are difficulties at an urination, temperature increases, skin over infiltrate reddens, fluctuation can be noted. If abscess is formed, then its spontaneous opening most often happens on a crotch, is more rare — in an urethra or a rectum.

Cooperite in most cases proceeds without clear subjective and objective symptoms, its current differs from inertly proceeding a little urethritis (see) and prostatitis (see). The diagnosis is based on data of the anamnesis, palpation, uretroskopiya (see), uretrografiya (see) and microscopy of a secret of gland. The swelling on a crotch sideways from the centerline, painful at a palpation, shall suggest an idea of cooperite.

Uretroskopiya allows to see the expanded mouth of an output channel of the struck gland, and at an uretrografiya filling with X-ray contrast liquid of a channel and the courses of segments of glands is observed.

In acute cases of gonorrheal cooperite the bed rest, hot compresses on a crotch, sedentary bathtubs, antibiotics, vaccinotherapy are shown. After elimination of an acute inflammation the struck gland treat using massage and a diathermy. At formation of abscess its opening is shown. At hron, a current more active thermal procedures, bougieurage of an urethra, systematic massage of gland are reasonable. At tubercular cooperite along with the corresponding antibacterial therapy sometimes happens operational removal of gland is necessary.

The forecast is usually favorable, at tubercular cooperite perhaps long current and a recurrence.



Bibliography: Vasilyev of A. I. Uretroskopiya and endourethral operations, L., 1955; L about p and t and A. I. O N an inflammation of kuperovy glands as a complication of a mecotic urethritis, Vestn, dermas, and veins., No. 8, page 79, 1969; Porudominsky I. M. Gonorrhea, M., 1952; The Guide to clinical urology, under the editorship of A. Ya. Pytel, M., 1969; T of PMC about in V. N. Textbook of normal anthropotomy, page 387, L., 1962.


F. A. Klepikov; R. I. Gertsenberg (An.).

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