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What does the female urethra look like

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Female Urethra Overview

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Urethral duplication UD in females is a rare congenital anomaly and requires a high degree of clinical suspicion for diagnosis. The preoperative evaluation requires thorough investigations to delineate anatomy which is imperative for surgical reconstruction to provide excellent functional and cosmetic outcome. We describe the successful management of a 6-year-old girl with UD presented as ambiguous genitalia and urinary incontinence along with a review of pertinent literature. Urethral duplication UD is a rare congenital anomaly and is characterized by two urethras, which may be either partial or complete.

The UD anatomy is different in males and females and hence the surgical management. The male UD divided into three types according to Effman's classification. A six-year-old child presented with ambiguous genitalia and urinary incontinence. The child had normal voiding and dribbling of urine from the abnormal perineal orifice vaginal orifice and had abnormal genitalia hypertrophied clitoris.

Physical examination revealed posterior displacement of the vaginal introitus and prominent clitoris with a narrow opening at the tip. No scrotal or labial structures were present and the perineum appeared flat and fused [ Figure 1 ]. On further evaluation, the child had female karyotype 46XX and sonography revealed normal Mullerian structures with normal kidneys and bladder.

Retrograde urethrogram RGU was attempted through the opening at the clitoris but catheter could not be passed through it. Subsequently, evaluation under anesthesia, cystogenitoscopy, and contrast study was done; we could identify one tiny opening at the clitoral tip, which was very narrow and only admitting guide wire for 2 cm.

During vaginoscopy, the vagina was roomy with the normal cervix. A urethral opening was present on the anterior wall of the vagina 2 cm proximal to vaginal orifice and it urethra led into the normal bladder. Urethrogram and genitogram were done under fluoroscopy and delineated the anatomy, suggestive of UD [ Figure 1 , Inset]. Subsequently, the patient underwent feminizing genitoplasty with urethral reconstruction.

The dorsal urethra was dissected, the distal 2 cm of the urethra was very narrow and atretic hence excised. The proximal portion of the dorsal urethra was well developed good caliber , joined to the ventral urethra near its confluence into the vagina [ Figure 2a ]. The ventral urethra was dissected till communication to the vaginal wall and disconnected. The rent in the anterior vaginal wall and ventral urethra was repaired and soft tissue interposed in between the two suture lines [ Figure 2b ].

The distal continuity of the ventral urethra with the dorsal urethra good caliber was maintained and neourethra i. Postoperative period was uneventful and the child was discharged after removal of all the catheters. On subsequent follow-up, the child had developed urethrovaginal fistula of 0. Six months later, urethrovaginal fistula was repaired successfully from the perineal approach. The child is under follow-up and continent for urine no urinary dribbling at last visit with normal upper tracts.

Inset showing preoperative anatomy. The vagina blue arrow and its confluence yellow arrow with the ventral urethra. Soft tissue interposition white arrow in between the repaired vagina and urethra. Inset showing postoperative anatomy. There is no embryological theory that explains all UD abnormalities.

Indications for surgery include annoying symptoms such as a double stream most common , urinary incontinence, ambiguous genitalia, perineal sinuses, urinary obstruction or infection, and associated genitourinary anomalies. The preoperative evaluation requires a variety of radiological investigations and endoscopic procedures to define the anatomy.

These include voiding cystourethrogram VCUG , RGU, intravenous urography, sonourethrography, magnetic resonance imaging, and cystogenitoscopy. VCUG and RGU should be carried out in lateral projections for visualization of the size, shape, and position of the two channels. Patients with UD can be asymptomatic and in such situation a conservative approach is acceptable. Most duplication occurs in the sagittal plane one on top of the other.

Less commonly, openings may lie collaterally side by side in the frontal plane. It is imperative to be aware of anatomy, continent status, and caliber of both the urethras during the preoperative evaluation. Usually the ventral urethra is continent and good caliber compared to the dorsal urethra; similar findings were present in the index case. During surgical planning, the facts to be considered are continent urethra should be preserved, good caliber urethra should be used for reconstruction purpose, and excision of accessory urethra should be accomplished.

The genital reconstruction depends on the severity of virilization. In our case, the child presented with incontinence over continence with ambiguous genitalia. Hence, we had started investigations on two lines: Ectopic ureter and disorder of sex development.

After cystogenitoscopy and contrast study, diagnosis was confirmed and anatomy of both urethras was well delineated. The incontinence was might be pseudo-incontinence because of the vaginal voiding, i. The roomy vagina was also suggestive of the possibility for such type of pathology. We had planned to preserve ventral urethra as it was a continent and well developed. Moreover, well-developed part of the dorsal urethra had been used for urethral reconstruction to achieve adequate length.

The occurrence of urethrovaginal fistula in the postoperative period was might be because of inadequate soft tissue interposition or overlapping suture line or due to vascularity-related issues.

As urethrovaginal fistula was distal to the bladder neck area, the eventual continence status was not compromised. UD is a rare cause for ambiguous genitalia in female and requires a high degree of clinical suspicion to diagnose the condition. The optimum management must be individualized and requires thorough investigations to delineate anatomy, which is crucial for surgical planning with the aim to provide excellent functional and cosmetic outcome.

National Center for Biotechnology Information , U. J Surg Tech Case Rep. Shailesh Solanki , M. Narendra Babu. Author information Copyright and License information Disclaimer. Address for correspondence: Dr. E-mail: moc. This article has been cited by other articles in PMC. Abstract Urethral duplication UD in females is a rare congenital anomaly and requires a high degree of clinical suspicion for diagnosis. Key words: Ambiguous genitalia, female pseudohermaphroditism, urethral duplication.

Open in a separate window. Figure 1. Figure 2. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Duplication of the urethra. MRI in congenital duplication of urethra. Indian J Radiol Imaging.

Casselman J, Williams DI. Acta Urol Belg. Das S, Brosman SA. Duplication of the male urethra. J Urol. Congenital posterior urethral perineal fistula: A case report. Support Center Support Center. External link. Please review our privacy policy.

Female reproductive system (urogenital system) anatomy

Finding the urethra and avoiding UTIs are two common problems encountered by female catheter users. Because the urethral opening is small, it is hard to see or feel it, and it is prone to be infected. It is also very prone to be infected. The urethra is a tube that connects the neck of your bladder to the urethral opening on your external genitals , where urine exits the body.

Urethra , duct that transmits urine from the bladder to the exterior of the body during urination. The urethra is held closed by the urethral sphincter, a muscular structure that helps keep urine in the bladder until voiding can occur. Because the urethra is anatomically linked with the reproductive structures, its characteristics in males are quite different from those in females.

Urethral duplication UD in females is a rare congenital anomaly and requires a high degree of clinical suspicion for diagnosis. The preoperative evaluation requires thorough investigations to delineate anatomy which is imperative for surgical reconstruction to provide excellent functional and cosmetic outcome. We describe the successful management of a 6-year-old girl with UD presented as ambiguous genitalia and urinary incontinence along with a review of pertinent literature. Urethral duplication UD is a rare congenital anomaly and is characterized by two urethras, which may be either partial or complete. The UD anatomy is different in males and females and hence the surgical management.

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The female urogenital tract consists of all the organs involved in reproduction and the formation and release of urine. It includes the kidneys , ureters , bladder , urethra , and the organs of reproduction — uterus , ovaries , fallopian tubes and vagina. The kidneys are bean shaped organs, which help the body produce urine to get rid of unwanted waste substances. When urine is formed, tubes called ureters transport it to the urinary bladder, where it is stored and excreted via the urethra. The uterus or womb is the major female reproductive organ, which supports and nourishes the developing baby. One end of the uterus called the cervix , opens into the vagina, whereas the other is connected on both sides to the fallopian tubes. These tubes connect with the ovaries, which are important in producing eggs and secreting hormones.

The Urethra

Urethritis occurs when the urethra is red and swollen inflamed. The urethra is the tube that passes urine from the bladder to outside the body. The urethra can get swollen and cause burning pain when you urinate. You may also have pain with sex.

In human females and other primates , the urethra connects to the urinary meatus above the vagina , [ citation needed ] whereas in marsupials , the female's urethra empties into the urogenital sinus.

The urinary meatus , [1] also known as the external urethral orifice , is the opening of the urethra. It is the point where urine exits the urethra in males and in females and where semen exits the urethra in males. The meatus has varying degrees of sensitivity to touch. The meatus is located on the glans of the penis or in the vulval vestibule.

Urinary meatus

The urethra is the vessel responsible for transporting urine from the bladder to an external opening in the perineum. It is lined by stratified columnar epithelium , which is protected from the corrosive urine by mucus secreting glands. In this article, we shall look at the anatomy of the male and female urethra — their anatomical course , neurovascular supply, and any clinical correlations. The male urethra is approximately cm long.

The urethra is a part of the renal system. The kidneys , ureters, and bladder are also part of this system. The renal system is responsible for producing, storing, and eliminating liquid waste in the form of urine. The urethra is closely linked with the reproductive organs, so the anatomy of the urethra is different between males and females. The female urethra begins at the bottom of the bladder, known as the neck.

Urethritis in Women

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The urethra is a tube that connects the neck of your bladder to the urethral opening on your external genitals, When you see your vagina, look a little bit up.

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