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Kytril (Granisetron)

The opening from the bladder is into the urethra, and is closed in both the male and female by the familiar sphincter type of muscle which acts as a puckering string, allowing no passage until it is relaxed. In the male, this first part of the urethra is entirely surrounded by the gland known as the prostate.
A goodly proportion of males would undoubtedly vote the prostate to be an unmitigated nuisance. The gland consists of several portions or lobes. For some reason which probably has to do with the endocrine system, it tends to enlarge in middle age or later. The enlargement interferes with the free passage of urine. Often the symptoms at first do not amount to much, but the time comes when the bladder is never completely empty. This situation results in frequent urination. The stagnant urine is easily infected, and the inflammation of the bladder may cause great irritation. The continued pressure may force urine back into the kidney, and particularly when inflammation is present, the kidney may be seriously damaged thereby. Men experiencing any of these symptoms or signs are wise to have an early examination, for enlargement of the prostate can usually be determined by a rectal examination. Often in the early stages, a little treatment or even the removal of a portion of the prostate through the urethra may be sufficient. In the late stages, when the kidney has been seriously injured, a great deal of preliminary treatment may be necessary before the patient is in condition to withstand the removal of the prostate.
In a philosophical attitude, aloof from the patient who has experienced these tribulations, we speak of all this as benign hypertrophy of the prostate. Benignity is certainly a comparative term in medicine. It simply means non-cancerous. Cancer of the prostate is much more serious than the benign enlargement. Paradoxically, it is not in the prostate itself but in the sheath which surrounds it in the back that it usually begins. Besides being difficult to remove it is particularly bad because like most cancers it has a tendency to metastasize (that is, jump) to the bones of the spine or elsewhere. If taken early, it can be handled in a good proportion of the cases by an extensive, elaborate operation.
Women have no prostates, but most women have babies, and their urinary apparatus is nearly as intimately associated with their genital system as is the situation in men. The bladder is closely attached to the front of the uterus and the urethra runs in the front wall of the vagina. Hence a large proportion of women who have gone through childbirth have had injury to their urinary apparatus. Undoubtedly the worst and most common of these, which resulted from the rougher obstetrics of the old days, was a vesico-vaginal fistula. This was a persistent opening between the bladder and the vagina; most distressing and most difficult to cure. I think it is rare now.
The prostate is part of the genital system and yet, as you have just seen, it plays a large part in the urinary system. In fact the two systems are so closely related that a distinct specialty combines the surgical care of the genito-urinary system. This is particularly necessary in the male where the genital system is elaborate and the lower portion of the urinary system, the urethra, is as much a genital organ as a urinary one. Until a generation or so ago there was a goodly number of practitioners who pretty well confined their practice to diseases of the urethra. Although the late developments of disease resulted in urinary difficulties to a large extent, yet the origin was nearly always genital.
In the woman the urethra is entirely a urinary organ but it is so closely associated with the vagina, a genital organ, that here again the gynecologist takes over its care. The human body was not designed for ease in classification. Simple-indexing would be impossible.

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