A case of accessory clitoris

A CASE

OF ACCESSORY

BY GEORGE A. WILLIAMS, (Prom

the Emory

University

CLITORlS

ND., Division

of

ATLANTA, GA. Grady Hospital)

A

BNORMALITIES of the clitoris are by no means rare, but they are usually associated with stigmas of epispadias. Under such conditions there is an arrest in the fusion of the two corpora cavernosa clitoridis; a maldeveloped body lies on each side of the genital cleft

Fig.

l.-External

genitalia

after

adhesions

were

freed

from

glans

of accessory

clitoris.

and the intervening space varies with the degree of epispadias as represented by exstrophy of the bladder and absence of the symphysis pubis. The features of the case herein reported differ radically from such findings, however, and are difficult to explain through embryologic phenomena. CASE

REPORT

A well-developed, well-nourishedcolored primipara, aged twenty-two years, was seenin the prenatal clinic in April, 1925. The pregnancy was normal and nothing unusual wag found except for the peculiar

condition

117

of the external genitalia.

118

THE

AMERICAN

JOURNAL

OF OBSTETRICS

AND

GYNECOLOGY

On casual inspection the vulva appeared to be normal, but on separating the labia minora a small cleft about 2 cm. in length was seen in the midline of the Further separnvestibule just below the frenum of a normally situated clitoris. tion of the labia induced a parting of the lips of the cleft, and a small rounded prom inence resembling a minute glans clitoris appeared in the upper portion thereof. The lips of the cleft were lightly adherent to this body. The ndhesions mere liberated by gentle probing, and a small amount of smegma was removed from the corona. The glans surmounted a shaft of similar proportions which on palpation was but, on account of the small size, found to extend toward the symphysis pubis; the exact attachments could not be determined. Libido was said to be normal; and although, for some time, the patient had been aware of the erectile body in question, she hod never questioned its presence being normal. 1121

CANDLER

BUILDING.

AMNIOTIC BY

IJESTER

(Professor

A.

WILSON,

of Obstetrica,

TROCAR

M.D., Medical

F.A.C.S.,

College

CHARLESTON,

of the Sta.te

of South

S. C. CarolinaJ

T

HE instrument herein illustrated has a hidden point for rupturing the fetal membranes guided by rectal examination. A sliding movement of the button situated on its handle projects the point, beyond the end of the trocar. The cervix and membranes are locnted by rectal examination after which the instrument is introduced vaginally against the membranes, and the point pressed forward. The membranes are then ruptured by a gentle movement of the instrument.

Fig.

l.-Trocar

This trocar can also be used for amination. It is especially valuable is fully dilated, for the purpose of when labor is to be induced by the This instrument can he obtained delphia, Pa. 105

RUTLEDGE

AVENZTE.

about

one-third

actual

size.

rupturing the bag of waters by vaginal exwhere it is desired to rupture before the cervix intraovular insertion of the hydrostatic bag or rupture method. from the Geo. P. Pilling & Son Co., of Phila-