CONGENITAL OBSTRUCTION OF THE POSTERIOR URETHRA: REPORT OF A CASE IN A BOY AGED FIVE YEARS
Archives of Pediatrics & Adolescent Medicine
Urethral obstruction to the urinary flow may be brought about by a number of conditions. They are for the most part the result of inflammatory processes in the urethra itself, or of pressure on its lumen by the growth of surrounding structures, notably in prostate hypertrophy. These changes acquired after birth are of frequent occurrence and are to be sharply distinguished from obstruction of the urethra present, although perhaps unrecognized, at the time of birth. Without other reference to
... her reference to the interference with the urinary flow from gross malformation of the genito-urinary tract, and to the stricture of the urethra due to occlusion or narrowing of its external orifice, or of the pars navicularis, we wish to report an instance of a form of congenital membranous obstruction occurring in the prostatic portion of the urethra, because apparently this condition has not attracted the attention, at least in this country, that it deserves, and it may be that cases which might be relived are not recognized. CASE REPORT History.-The case reported concerned a boy, F. S., aged 5 years. His family history was good; his father and mother were living, five brothers and four sis¬ ters were alive and well, and had no symptoms similar to those of the patient. The birth was normal. From infancy it was noted that there was frequency of micturition. It was necessary for the patient always to wear napkins, which were wet, according to the mother's statement, "about every half hour." The urine was described as often being "thick and milk-like." Otherwise the patient's life was uneventful until 3 years of age, when he had measles. Following this illness the patient seemed susceptible to colds and had much of the time a puru¬ lent discharge from the left ear. He first came under the observation of one of us on June 26, 1911, when at the age of 4 years, he was admitted to The Thomas Wilson Sanitarium complain¬ ing of loss of weight and strength and moderate diarrhea. Examination.-On examination the boy was found to be sparely nourished, pale and with evidences of rickets-marked Harrison's grooves and a moderate rosary. His weight was 23 pounds. The lungs and heart were normal. The abdomen was considerably distended and pendant. On palpation in the left lumbar region there was made out a soft movable lobulated mass extending from the anterior superior spine to the costal margin and to about midway between the umbilicus and the lateral border of the abdomen.