Elsevier

Urology

Volume 73, Issue 5, May 2009, Pages 1008-1011
Urology

Pediatric Urology
Diagnosis and Treatment of Urethral Prolapse in Children: Experience With 34 Cases

https://doi.org/10.1016/j.urology.2008.10.063Get rights and content

Objectives

To retrospectively review 34 cases of urethral prolapse at an inner-city institution with an emphasis on diagnosis and treatment in the pediatric population.

Methods

We performed a retrospective chart review of 34 patients of all age groups with urethral prolapse treated at our institution and reviewed the relevant published data.

Results

A total of 34 patients with urethral prolapse were treated at our institution during a 23-year period. The diagnosis was made mainly by physical examination. The findings from the history, physical examination, and pertinent laboratory investigations were reviewed. Most patients were treated successfully with excision of the prolapsed mucosa circumferentially over a Foley catheter and discharged home within 24 hours of the operation. No major complications occurred.

Conclusions

Urethral prolapse primarily affects premenarchal black girls and should be treated promptly with excision of the prolapsed mucosa and early hospital discharge.

Section snippets

Material and Methods

The charts of 34 patients with the diagnosis of urethral prolapse from 1983 to 2006 were reviewed. When reviewing the hospital database for urethral prolapse (“International Classification of Diseases” code 599.5), 60 patients were listed from 1983 to 2006. However, only 34 charts were applicable to children. The cases were examined secondary to chart availability. The variables considered were age at diagnosis, presenting symptoms, urinalysis findings, race, weight with percentile, treatment

Results

All 34 patients were black girls with an average age of 5.4 years (range 5 months to 12 years). All 34 pediatric patients presented with a chief complaint of vaginal bleeding or blood on their undergarments. Of the 34 patients, 10 also had urinary symptoms of dysuria, frequency, or urgency. On physical examination, all patients had a protruding, congested, and edematous bleeding, fleshy mass surrounding the external urethral meatus. The urinalysis report was available for 32 of the 34 children.

Comment

Urethral prolapse is a rare benign condition that involves the distal urethra.6 Although this condition is rare, it should always be considered in the differential diagnosis of any girl with vaginal bleeding.7 It occurs most commonly in prepubertal black girls and postmenopausal white women.6, 7 The exact etiology of urethral prolapse remains unknown. Two main theories have been proposed, congenital vs acquired.5 The most popular theory was proposed by Lowe et al.,6 who described urethral

References (13)

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