Paraurethral gland

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Drawing of the anatomical structure of the paraurethral glands of an adult woman. The female urethra is shown , over a length of approx. 3 cm - Meatus urethrae externus, picture below - with the glandular outlets that open from the ventral or dorsal side .

As paraurethral gland ( Latin glandula paraurethralis ) or Skene gland (after Alexander Skene ) or prostate feminina (Latin 'female prostate') are accessory sex glands of women in anatomy .

View of the ( intravaginal ) periurethal cavernous tissue. The clitoris is at the bottom of the picture. Above it the urethral opening, Meatus urethrae externus , it is closed and visible as a small elevation.
Female genitalia with glans of the clitoris , labia minora , urethral opening , external (inconsistent) orifice of the paraurethral gland, vaginal entrance and orifice of Bartholin's gland

These glands have several ducts. These open into the end section of the urethra and (possibly) to the right and left of the same. Their secretion (see female ejaculation ) is similar in composition and enzyme pattern to the male prostate secretion ( prostate-specific antigen ).

History of science

The French surgeon Alphonse Guérin (1817–1895) was the first to describe these glands, but they were named after the Scottish gynecologist Alexander Skene, who was the first to report on them in 1880 in the medical literature. Therefore they are also called prostate feminina , although this part of the female sex organ is not an organ that is homologous to the male prostate .

A number of observations and publications preceded the final and therefore recognized description in medicine. In 1672, the Dutch anatomist Reinier de Graaf observed duct- like structures in the immediate vicinity of the mouth of the female urethra ( meatus urethrae ). In 1853, Rudolf Virchow described pathological changes in 'canals' that surround the urethral canal. He found stone-like masses inside and assumed that the urethral glands and ducts were homologous to the male prostate. In 1889 F. Tourneux described these glands in a similar way and confirmed this hypothesis. Gustaf Pallin (1877–1957), however, claims in 1901 that the paraurethral glands are not homologous to the male prostate in their entirety, but in their respective cranial and ventral parts.

Anatomical location and function

The inner labia , labia minora, enclose the vaginal vestibule into which the urethra , urethra femina, opens. The paraurethral glands (also called Skene glands) also open into the urethra and occasionally next to the mouth opening, Meatus urethrae externus of the urethra, they secrete a thin fluid secretion as part of the female orgasm during the so-called female ejaculation . According to Huffman (1948/1951), the mouth of the female prostate lateral to the mouth of the urethra, Meatus urethrae externus , is the exception. He saw this condition only in connection with a postnatal condition ( postpartum ).

From 1985 to 1999, Milan Zaviačič examined the anatomy, histology, pathology and function of the paraurethral glands in 150 autopsies on 200 patients. He described different anatomical shapes and was able to classify them in a table.

According to Zaviačič (1998), the female prostate can be divided into different types. In the anterior , proximal or meatal type, the prostate-like tissue is most clearly located in the distal third of the female urethra, i.e. in the anterior urethra and directly behind the urethral orifice ( meatus urethrae ). This is the most common type, seen 66% of the time. In 10% of cases, the posterior or distal type shows the greatest amount of prostate tissue and was found in the posterior urethra, which extends to the bladder neck. In 8% of cases, the rudimentary type shows a small number of glands and ducts found throughout the urethra. In 6% of cases, another type shows prostate tissue along the entire urethra.

Paraurethral gland ("Skene gland") with the G-spot located in the ("ring-shaped") periurethral connective tissue, sketch in the sagittal plane
Type Forms of the paraurethral glands in relation to their location in relation to the urethra
1 distal (meatal type)
2 Proximal type
3 Gland running the length of the urethra
4th Rudimentary glands
5 Glands in the middle of the urethra
6th so-called dumbbell-shaped gland configuration

The morphology of the paraurethral glands is highly variable and they can occasionally be absent entirely. Not only their anatomical characteristics are variable, but also the extent of their functionality or secretion ( female ejaculation ). Female ejaculation can be caused by the "orgasming" woman u. a. go completely unnoticed, because, like a man, retrograde ejaculation into the bladder is also possible with a woman.

The paraurethral glands, glandulae paraurethrales , have several excretory ducts and open both into the end section of the urethra (“intraluminal”) itself and laterally (“periurethral”) thereof. The urethra has a urothelial layer in its initial part, close to the bladder , which merges into a multi-layered, uncornified squamous epithelium in the distal direction. Occasionally there are mucous glands , urethral glands . The mucous membrane also forms bays, lacunae urethralis and longitudinal folds that contain the branched, tubular glandulae urethrales . In the distal third of the "intraluminal" Drüsenausführgange the Skene's gland, are Glandulae paraurethrales detectable.

Comparison of the embryonic development of the male prostate and the female Skene glands

Ontogenetically , the male prostate arises from the epithelial buds of the pars pelvina of the urogenital sinus . Androgens stimulate the development of the mesenchymal and epithelial parts of the prostate. The primitive prostate epithelium differentiates itself under the influence of androgens into the three glandular cell types of the prostate: basal cells, luminal cells and neuroendocrine cells.

Although some reports indicate that Skene's glands may not be paralogous to the male prostate because they lie caudally along the urogenital sinus, other studies (Huffman, 1948; Thomson et al., 2002; Timms et al., 1999) have found prostate-like ones Epithelial buds identified in women that occur in regions comparable to prostate buds in men. It is possible that low androgen levels in connection with androgen receptor expression in the female mesenchyme could be sufficient for the induction of prostate-like buds in women (Thomson, 2008).

Function and innervation

In the male prostate, the secretion of the tubuloazine , apocrine glandular epithelium is stimulated by parasympathetic nerve impulses. In contrast, the contraction of the smooth muscle cells and thus the consecutive excretion of the prostate secretion into the duct system is stimulated by sympathetic nerve fibers. The types of Skene glands capable of excretion (Zaviačič 199) have an analogous, vegetative regulation (see the different activities of the vegetative part during sexual arousal, female arousal phases ).

Pathological changes

Cyst on the side of the duct of Skene's gland

Occasionally there may be inflammation are the Skene's gland, called Skenitis . Also, the tumorous degeneration ( carcinoma ) has been described and show similarities to the male prostate . The excretory ducts of the paraurethral gland can be the starting point for the formation of urethral diverticula or lead to retention cysts .

See also

literature

  • Frank Addiego, Edwin G. Belzer Jr., Jill Comolli, William Moger, John D. Perry, Beverly Whipple: Female Ejaculation: A Case Study. In: The Journal of Sex Research. Volume 17, No. 1, February 1981, pp. 13-21.
  • Annette Bolz: The water of profligacy. Female ejaculation isn't a myth, even if it's not in the textbook. Modern science is hesitant to research this. In: The time . No. 45, November 5, 1993.
  • Thalita Cristina M. Costa, Patrícia M. Cury, Ana Maria G. Custódio: Features of the female prostate according to age: an autopsy study. Características da próstata feminina de acordo com a idade: um estudo de autópsia. J Bras Patol Med Lab, v. 52, n. 4, pp. 246-252, August 2016 [6]
  • Gautam Dagur, Kelly Warren, Reese Imhof, Jacquelyn Gonka, Yiji Suh, Sardar A. Khan: Clinical implications of the forgotten Skene's glands: A review of current literature. In: Polish annals of medicine. 2016, Volume 23, pp. 182–190 ( full text as PDF ).
  • Ruben F. Gittes, Robert M. Nakamura: Female Urethral Syndrome. A Female Prostatitis? In: WJM . May 1996, Volume 164, No. 5 [7]
  • Ernst Graefenberg : The Role of Urethra in Female Orgasm. In: The International Journal of Sexology. Volume 3, No. 3, 1950, pp. 145-148.
  • Stephanie Haerdle: Syringes . History of female ejaculation . Edition Nautilus, Hamburg 2020, ISBN 978-3-96054-215-5 .
  • John W. Huffman: Clinical significance of the paraurethral ducts and glands. In: AMA archives of surgery. June 1951, Volume 62, No. 5, pp. 615-26, doi: 10.1001 / archsurg.1951.01250030625002 .
  • John W. Huffman: The detailed anatomy of the paraurethral ducts in the adult human female. Am J Obstet Gynecol, 1948; 55: 86-101
  • Alice Khan Ladas, Beverly Whipple, John D. Perry: The G-Spot. The strongest erotic center of women (= Heyne general series. No. 7221). Heyne, Munich 1983, ISBN 3-453-01806-0 . (English edition: The G spot: and other discoveries about human sexuality. 1st Owl Books edition. Holt Paperbacks, New York 2005, ISBN 0-8050-7759-6 (first edition 1982)).
  • Sabine zur Nieden: Female ejaculation. Variations on an ancient dispute between the sexes. (= Contributions to sex research. Volume 91). 2nd Edition. Psychosozial-Verlag, Giessen 2009, ISBN 978-3-8379-2004-8 . (First edition: Enke-Verlag, Stuttgart 2004; dissertation University of Frankfurt am Main 1991, under the title: Theoretical and empirical studies on female ejaculation ).
  • Samuel Salama, Florence Boitrelle u. a .: Nature and Origin of “Squirting” in Female Sexuality. In: The Journal of Sexual Medicine. Volume 12, No. 3, 2015, pp. 661-666, doi: 10.1111 / jsm.12799 .
  • Josephine Lowndes Sevely: Eva's Secrets. New insights into the sexuality of women. Droemer Knaur, Munich 1988, ISBN 3-426-26363-7 .
  • Karl F. Stifter: Female ejaculation. In: W. Eicher et al. (Ed.): Practical Sexual Medicine. Medical Tribune, Wiesbaden 1988, p. 95 f.
  • Deborah Sundahl: Female Ejaculation and the G-Spot. Nietsch, Freiburg im Breisgau 2006, ISBN 3-934647-95-2 .
  • Renate Syed: About the "Graefenberg Zone" and female ejaculation in ancient Indian sexology. A contribution to the history of medicine. In: Sudhoff's archive. Journal of the History of Science. Volume 83, Issue 2, 1999, pp. 171-190.
  • Nicole Szell, Barry Komisaruk, Sue W. Goldstein, Xianggui (Harvey) Qu, Michael Shaw, Irwin Goldstein: A Meta-Analysis Detailing Overall Sexual Function and Orgasmic Function in Women Undergoing Midurethral Sling Surgery for Stress Incontinence. In: Sexual Medicine. 2017, Volume 5, e84 – ee93 ( PDF 1.31 MB; 10 pages on smoa.jsexmed.org)
  • Florian Wimpissinger, Karl Stifter, Wolfgang Grin, Walter Stackl: The Female Prostate Revisited: Perineal Ultrasound and Biochemical Studies of Female Ejaculate. In: The Journal of Sexual Medicine. September 2007, Volume 4, No. 5, pp. 1388-1393, doi: 10.1111 / j.1743-6109.2007.00542.x .
  • Florian Wimpissinger, Robert Tscherney, Walter Stackl: Magnetic Resonance Imaging of Female Prostate Pathology. In: The Journal of Sexual Medicine. June 2009, Volume 6, No. 6, pp. 1704-1711, doi: 10.1111 / j.1743-6109.2009.01287.x .
  • Florian Wimpissinger, Christopher Springer, Walter Stackl: International online survey: female ejaculation has a positive impact on women's and their partners' sexual lives. In: BJU International. July 2013, Volume 112, No. 2, pp. E177-E185, doi: 10.1111 / j.1464-410X.2012.11562.x .
  • Florian Wimpissinger: The female prostate - fact or myth? In: urology. Volume 2/07, pp. 18-20, full text (PDF).
  • Milan Zaviačič , Beverly Whipple: Update on the female prostate and the phenomenon of female ejaculation . In: Journal of Sex Research . Volume 30, 1993, pp. 148-151.
  • Milan Zaviačič: The Human Female Prostate: From Vestigial Skene's Paraurethral Glands and Ducts to Woman's Functional Prostate . Slovak Academic Press, Bratislava 1999, ISBN 978-80-88908-50-0 .

Web links

Individual evidence

  1. ^ JW Huffman: The detailed anatomy of the paraurethral ducts in the adult human female. Am J Obstet Gynecol, 1948; 55: 86-101
  2. ↑ Alexander JC Skene: The anatomy and pathology of two important glands of the female urethra. William Wood, New York 1880. [1] .
  3. ↑ Representation of the individual accessory glands in women . Drawing on: urologie3400.at , last accessed on November 14, 2014.
  4. ↑ Milan Zaviacic, RJ Ablin: The female prostate and prostate-specific antigen. Immunohistochemical localization, implications of this prostate marker in women and reasons for using the term "prostate" in the human female. In: Histology and Histopathology. 2000, Volume 15, No. 1 ( full text ).
  5. ↑ Wax model of the paraurethral glands from Zaviacic et al. [2]
  6. ↑ Wax model of the paraurethral glands from Zaviacic et al. [3]
  7. ↑ Milan Zaviacic, Beverly Whipple: Update on the Female Prostate and the Phenomenon of Female Ejaculation. In: The Journal of Sex Research. May 1993, Vol. 30, No. 2, pp. 148-151.
  8. ↑ Florian Wimpissinger: The female prostate - fact or myth? In: urology. Volume 2/07, p. 19.
  9. ↑ Christoph Weißer: Guérin, Alphonse-Françoise-Marie. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 515.
  10. ↑ Alexander Johnston Chalmers Skene: The anatomy and pathology of two important glands of the female urethra. In: American journal of obstetrics and diseases of women and children. (Am J Obs Dis Women Child.) April 1880, Vol. 13, No. 2, pp. 265-70; Reprint: William Wood & Co, New York 1880.
  11. ↑ MF Tourneux: Sur la structure des glandes uréthrales (prostatiques) chez la femme, et sur les premiers développements des glandes prostatiques dans les deux sexes. Cpt. rend. des séances de la soc. de biol. 1888.
  12. ^ Gustav Pallin: Contributions to the anatomy and embryology of the prostate and the seminal vesicles. In: Archives for Anatomy. (Lpz.) 1901, pp. 135-176.
  13. ↑ Karl F. Stifter: The third dimension of pleasure. The secret of female ejaculation. Wilhelm Heyne, Munich 1990, ISBN 3-453-04011-2 , p. 185.
  14. ↑ H. Ümit Sayin: Doors of Female Orgasmic Consciousness: New Theories on the Peak Experience and Mechanisms of Female Orgasm and Expanded Sexual Response. In: NeuroQuantology. November 2012, Volume 10, No. 4. P. 692-714, doi : 10.14704 / nq.2012.10.4.627 , see P. 697 / 298463859_Doors_of_Female_Orgasmic_Consciousness_New_Theories_on_the_Peak_Experience_and_Mechanisms_of_Female_Orgasm_Sand_Expand
  15. ↑ Robert King, Jay Belsky, Kenneth Mah, Yitzchak Binik: Are There Different Types of Female Orgasm? In: Archive for Sexual Behavior , doi : 10.1007 / s10508-010-9639-7 PDF
  16. ↑ Kenneth Mah, Yitzchak M. Binik: The nature of human orgasm: A critical review of major trends. In: Clinical Psychology Review. 2001, Volume 21, No. 6, pp. 823-856, ( full text as PDF ).
  17. ↑ M. Zaviačič, Jakubovský J. Sloboda et al .: Metastasizing adenocarcinoma of the female prostate (Skene's paraurethral glands). Histological and immunohistochemical prostate marker studies and first ultrastructural observation. In: Pathol Res Pract. 1998, Volume 194, pp. 129-136.
  18. ↑ Milan Zaviacic, RJ Ablin: The female prostate and prostate-specific antigen. Immunohistochemical localization, implications of this prostate marker in women and reasons for using the term "prostate" in the human female. In: Histology and Histopathology. 2000 Volume 15, No. 1 ( full text )
  19. ↑ Milan Zaviacic, Beverly Whipple: Update on the Female Prostate and the Phenomenon of Female Ejaculation. In: The Journal of Sex Research. May 1993, Vol. 30, No. 2, pp. 148-151
  20. ↑ Milan Zaviačič; Beverly Whipple: Update on the Female Prostate and the Phenomenon of Female Ejaculation . In: The Journal of Sex Research. Volume 30, Number 2, May 1993, pp. 148-151.
  21. ↑ Zaviacic sexo 4 . medpdffinder.com; accessed on November 14, 2014.
  22. ↑ Renate Lüllmann-Rauch: Pocket textbook histology . 4th edition, Thieme, Stuttgart 2012, ISBN 3-13-129244-X , p. 488.
  23. ↑ Thomas Deller: Histology - The textbook Elsevier Health Sciences, Munich 2018, ISBN 978-3-4371-8366-9 , p. 491 [4] books.google.de.
  24. ↑ JW Huffman: The detailed anatomy of the para-urethral ducts in the adult human female. In: Am. J. Obstet. Gynecol. 1948, vol. 55, pp. 86-101.
  25. ^ AA Thomson, BG Timms, L. Barton, GR Cunha, OC Grace: The role of smooth muscle in regulating prostatic induction. In: Development. 2002, Volume 129, pp. 1905-1912.
  26. ^ BG Timms, SL Petersen, FS vom Saal: Prostate gland growth during development is stimulated in both male and female rat fetuses by intrauterine proximity to female fetuses. In: J. Urol. 1999, Volume 161, pp. 1694-1701.
  27. ↑ Roxanne Toivanen, Michael M. Shen: Prostate organogenesis: tissue induction, hormonal regulation and cell type specification. In: Development. April 15, 2017, Volume 144, No. 8: pp. 1382-1398 PMC 5399670 (free full text).
  28. ^ AA Thomson: Mesenchymal mechanisms in prostate organogenesis. In: Differentiation. 2008, Volume 76, pp. 587-598.
  29. ↑ Aline C. Tregnago, Jonathan I. Epstein: Skene's Glands Adenocarcinoma. A Series of 4 Cases. Am J Surg Pathol, Volume 42, Number 11, November 2018 [5]
  30. ↑ A. Pongtippan, A. Malpica, C. Levenback et al .: Skene's gland adenocarcinoma resembling prostatic adenocarcinoma. In: International journal of gynecological pathology. (Int J Gynecol Pathol.) January 2004, Vol. 23, No. 1, pp. 71-4, PMID 14668555 .
  31. ↑ Leonardo Oliveira Reis, Athanase Billis, Fábio T. Ferreira et al .: Female urethral carcinoma: Evidences to origin from Skene's glands. In: Urologic oncology. March-April 2011, Volume 29, No. 2, pp. 218-23, doi: 10.1016 / j.urolonc.2009.03.019 .