This pain assumes often a spasmodic character; that there is a cause for this is certain, but it is as a rule remote from the sensation which attracts attention. It is often found to be the symptom of some of the diseases to which I have already referred. These are ulcerations, displacements, or inflammation and congestion of the neighboring organs. Abnormal growths or tissues will often be painfully reflected on the nerves of the urethra. I remember a case of internal hemorrhoids, which was never suspected by the patient because there were no painful symptoms pointing to the rectum, but in which the urethra was very painful in its entire extent. The suffering from this urethral neuralgia had lasted for years, but disappeared at once, on the removal of the piles. I have called attention to a catarrhal inflammation of the urethra, from stretching occasioned by the ascending womb after the third month of pregnancy; there is a similar pathological process after the seventh month of gestation, when the pregnant womb begins to descend again into the pelvic cavity, and this is particularly marked in the pregnancy with the first child, when the pain is often very severe.
If in a first pregnancy there is no abnormal disproportion between the dimensions of the child’s head and the maternal pelvis, or if there be no abnormal position of the child, then there is an obstetric rule that the womb, or rather the child’s head, begins to descend into the pelvis after the seventh month of gestation, so that it can accommodate or conform itself to the maternal parts. This occasions a drag on the urethra downwards and backwards, which is painfully annoying, and there is a constant inclination to pass water.
There are two mechanical methods of relieving this distressing symptom; one is to obtain as much rest as possible in the recumbent position, and the other is to wear an abdominal supporter or bandage around the lower abdominal region, so as to take the weight off the urethra. The internal medication consists of an occasional dose of a mild laxative medicine.
In the newly married, the urethra becomes sometimes the seat of a painful spasmodic contraction; this is due to a tense hymen, which should be slightly nicked with a pair of scissors. Exposures to colds will also cause neuralgia. Fresh beer and sour wine make the urine irritating, and also occasion painful symptoms.
A thorough examination of the mucous membrane of the urethra which does not reveal any inflammatory condition or abnormal growth, establishes its neuralgic character. The next step will naturally be to make such a careful examination of all the surrounding tissues and organs, for the purpose of ferreting out the real cause. When the cause is removed or cured, it will also relieve the urethral pain. In the absence of a clear comprehension of the true nature of the malady, the treatment must be palliative. The sitz-bath is always one of the most palliative measures for all sorts of pelvic pains and aches. Vaginal injections of hot water, not too hot, from 105 degrees to 108 degrees, are another sort of general panacea,—the quantity of fluid should be large, from half to one gallon, in which a teaspoonful of pulverized borax has been dissolved. If the pain is very severe, then a Femina vaginal capsule should be used every night before retiring, and immediately after having used the vaginal irrigation. The bed should always be previously warmed with a hot bottle, unless it is very warm weather.
If the urine is irritating, a cupful of buchu tea three or four times a day, or German chamomile tea, should be drunk between meals. If these measures do not give relief, then consult an honest, competent physician, in whose integrity you can rely.