A case report of urethral prolapse in young girls: Clinical manifestations and surgical management

• Published in: International journal of surgery case reports Vol. 120; p. 109879
• Main Authors: Hidouri, Saida, Ammar, Sabrine Ben, Mosbahi, Sana, Chaouch, Mohamed Ali, Gafsi, Besma, Mekki, Mongi
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.07.2024; Elsevier
• Subjects: Case report; Case Series; Clinical manifestations; Surgical management; Urethral prolapse; Young girls; Clinical manifestations; Urethral prolapse; Surgical management; Case report; Young girls
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2024.109879

Urethral Prolapse (UP), first described by Solinger in 1732, is a rare condition characterized by the circular protrusion of the distal urethral mucosa through the external meatus, forming a hemorrhagic, sensitive vulvar mass. This condition is most commonly observed in prepubertal black females. This case report details the clinical manifestations and surgical management of UP in three young girls. Three girls, aged 4, 5, and 6 years, were admitted with symptoms of vaginal blood spotting. Physical examinations revealed moderate bleeding and a red ring of congested, edematous tissue prolapsing through the urethral meatus. Diagnostic procedures confirmed UP, and surgical management was undertaken. The surgical approach involved the complete excision of the prolapsed tissue and mucosal-to-mucosal anastomosis under general anaesthesia. Postoperative follow-up over a mean period of 11 years showed no recurrence or urethral stricture. UP is a rare benign condition primarily affecting the female urethra, with several hypothesized etiologies, including weak pelvic floor structures and increased intraabdominal pressure. The typical presentation includes vaginal bleeding and a doughnut-shaped mass around the urethral meatus. Conservative management may be considered for mild cases, but surgical excision is recommended for severe cases, offering a safe and effective solution with low recurrence rates. UP in children, although rare, should be considered in cases of unexplained vaginal bleeding. Diagnosis is primarily clinical, and surgical resection provides a definitive and cost-effective treatment. •Urethral prolapse (UP) was identified in three young girls, aged 4, 5, and 6, who presented with vaginal blood spotting. Physical examinations revealed a red ring of congested, edematous tissue prolapsing through the urethral meatus, confirmed by diagnostic procedures.•All patients underwent successful surgical management involving complete excision of the prolapsed tissue and mucosal-to-mucosal anastomosis under general anaesthesia. Postoperative follow-up over 11 years showed no recurrence or urethral stricture, demonstrating the effectiveness and safety of the surgical approach.•Despite its rarity, urethral prolapse should be considered in the differential diagnosis of vaginal bleeding in young girls. The typical presentation and clinical assessment are crucial for diagnosis, with surgical intervention providing a definitive treatment option with low recurrence rates.