Anomalies of the external urethral orifice in girls.

In analyzing 1,000 of 1,475 micturating cystourethrograms in girls, the absolute number and the percentages of the different variations of the urethra were related to the frequency of urethrovaginal reflux and to anomalies of the meatus. This allowed the following deductions: There are no radiological findings in these girls that indicate the presence of subvesical obstruction. Anomalies of the meatus cannot be related to variations of the urethra as seen in the micturating cystourethrogram. They can, however, be the cause of enuresis, chronic urinary infection, urethrovaginal reflux, and disturbances in micturition. The marked susceptibility for chronic urinary infection seen in girls between the ages of 3 to 13 years is as yet not fully explained. The fact that the urethra opens near the anus and the vagina, inadequate hygiene, a too short urethra, and possibly missing hormonal protection against ascending infection, as well as the special urological anomalies described above, may all be responsible. Therefore, in girls there are a number of other disturbances micturition apart from of organic subvesical obstruction. These other disturbances may be termed functional, or the urethra syndrome.