A contribution to the morphology of the human urinogenital tract, and, Contributions to the pathology of the bladder and ureter : extroversio vesicae and apparent low implantation of the ureter end / by D. Berry Hart.

  • Hart, D. Berry (David Berry), 1851-1920.
Date:
1901
Catalogue details

Licence: In copyright

Credit: A contribution to the morphology of the human urinogenital tract, and, Contributions to the pathology of the bladder and ureter : extroversio vesicae and apparent low implantation of the ureter end / by D. Berry Hart. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Benckiser records two cases. In the first the lower ureteric opening was originally outside and below the urethral orifice. After two operations by ligature by Sanger, a fistula formed in the upper third of the vagina and to the right side. Implanta- tion into the bladder was refused. Benckiser’s second case is interesting, as the lower opening of the ureter was immediately below the urethral orifice. This was sounded with difficulty, until by temporary closure of the orifice the tube became dilated. The ureteric sound could then be passed to the level of the linea innominata. The kidney was somewhat deep, and on cystoscopic examination two ureteric orifices were found in the bladder. Benckiser believes there was thus a third ureter, but this does not quite follow. On operation he removed the lowest part of the abnormal ureter, and thus turned the lower aperture of the remaining part into the bladder. Microscopically the portion removed was found to be ureter in structure. I postpone consideration of Benckiser’s explanations of his cases to a subsequent part of this paper. The last paper is by Olshausen, who records two cases. In the first, a girl, ten years old, the abnormal opening was to the right of the hymen. The right ureteric opening was not present in the bladder. In the second case, a girl of fifteen, the lower opening lay to the right and a little below the urethral orifice. After several attempts the patient was cured by turn- ing the ureter into the bladder. The excised portions were found structurally to be ureter. Benckiser states that Schwarz had collected 25 cases of abnormal opening of the ureter, and 23 where the ureter ended blindly. Olshausen draws attention to valuable papers by Tangl and Seycheron. Tangl’s case is interesting, as the left ureter and Wolffian duct ended blindly, close to one another, in the anterior vaginal wall. Seycheron’s paper gives a very full resumd of cases of ureteric anomalies, and discusses the causes fully. In the typical case of apparent abnormal low opening of the ureter, the orifice is near the urethral orifice or hymen edge: in one case (von Massari) it was on the left edge of the