Abstract
The diseases of the vascular system which cause hæmorrhage from the genito-urinary tract are:—
(1) Those in which changes are noted in the blood and capillary endothelium, and
(2) Those in which alterations of a pathological nature are taking place in the walls of both large and small blood-vessels, but in which there is no change in the blood itself.
In the first group are the purpuras; in the second arteriosclerosis, hyperpiesis and atheroma.
This paper is confined to a discussion of the latter group of diseases in relation to genito-urinary hæmorrhage.
Little attention has been paid to sudden loss of blood from the kidney, bladder, or genitalia in support of a diagnosis of a vascular lesion, other than angioma. Hæmorrhage in these cases may be purely renal, vesical, or penile.
Investigations consist of examination of the superficial arteries, estimation of the blood-pressure, examination of the blood and cystoscopy. Surgical lesions must be excluded by the usual well-known methods.
A careful record has been kept of fifteen cases of arteriosclerosis in which hæmorrhage from the genito-urinary tract has been the predominant manifestation of the disease. Details are given of nine patients with renal, one with vesical and three with urethral hæmorrhage. Two cases of thrombosis of the penis are also included.
From a study of the literature here the cases of urethral hæmorrhage and thrombosis of the penis, recorded as due to arterial disease, appear to be unique.