Abstract
Introduction and Hypothesis
Urethral mucosal prolapse is most frequently seen in children and postmenopausal women, and extremely rare in young adult patients. In this context, we aim to describe our experience with this condition and compare our findings with the literature.
Methods
We reviewed the medical records of our outpatient micturition disorders clinic (between August 2014 and April 2017) for patients with a diagnosis of urethral mucosal prolapse, seeking to evaluate their demographic characteristics, presenting complaints, treatment, and outcomes.
Results
We found 12 cases of urethral mucosal prolapse, including a mother and daughter and a reproductive-aged patient. Presenting symptoms included bleeding, urinary retention, partially thrombosed mucosa, and pain. Misdiagnosis was common and caused treatment delay, even in some very symptomatic patients.
Conclusion
Urethral mucosal prolapse is a readily diagnosed condition and often associated with complications in our series. Proper diagnosis is key to successful, timely treatment. Descriptive studies such as this are important to raise awareness of this diagnosis and improve patient care.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Wei Y, Wu SD, Lin T, et al. Diagnosis and treatment of urethral prolapse in children: 16 years’ experience with 89 Chinese girls. Arab J Urol. 2017;15(3):248–53. https://doi.org/10.1016/j.aju.2017.03.004.
Jessop ML, Zaslau S, Al-Omar O. A case of strangulated urethral prolapse in a premenopausal adult female. Case Rep Urol. 2016;2016:1802623. https://doi.org/10.1155/2016/1802623.
Arzubi-Hughes MK, Salts LA, et al. Diagnosing and managing common genital emergencies in pediatric girls. Pediatr Emerg Med Pract. 2018;15(10):1–23.
Hall ME, Oyesanya T, Cameron AP. Results of surgical excision of urethral prolapse in symptomatic patients. Neurourol Urodyn. 2017;36(8):2049–55. https://doi.org/10.1002/nau.23232.
Olumide A, Kayode Olusegun A, Babatola B. Urethral mucosa prolapse in an 18-year-old adolescent. Case Rep Obstet Gynecol. 2013;2013:231709. https://doi.org/10.1155/2013/231709.
Ninomiya T, Koga H. Clinical characteristics of urethral prolapse in Japanese children. Pediatr Int. 2017;59(5):578–82. https://doi.org/10.1111/ped.13226.
Holbrook C, Misra D. Surgical management of urethral prolapse in girls: 13 years’ experience. BJU Int. 2012;110(1):132–4. https://doi.org/10.1111/j.1464-410X.2011.10752.x.
Dorado M, Molina R, Álvarez M, et al. Urethral prolapse, is surgical treatment necessary? Arch Esp Urol. 2019;72(6):619–20.
Schreiner L, Nygaard CC, Anschau F. Urethral prolapse in premenopausal, healthy adult woman. Int Urogynecol J. 2013;24(2):353–4. https://doi.org/10.1007/s00192-012-1820-1.
Hill AJ, Siff L, Vasavada SP, et al. Surgical excision of urethral prolapse. Int Urogynecol J. 2016;27(10):1601–3. https://doi.org/10.1007/s00192-016-3021-9.
Fiogbe MA, Hounnou GM, Koura A, et al. Urethral mucosal prolapse in young girls: a report of nine cases in Cotonou. Afr J Paediatr Surg. 2011;8(1):12–4. https://doi.org/10.4103/0189-6725.78661.
Ballouhey Q, Abbo O, Sanson S, et al. Urogenital bleeding revealing urethral prolapse in a prepubertal girl. Gynecol Obstet Fertil. 2013;41(6):404–6. https://doi.org/10.1016/j.gyobfe.2013.04.006.
Levin P, Harvie HS, Guerette NL. Novel approach for correction of urethral prolapse using a retropubic sling with urethral fixation. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(8):995–7. https://doi.org/10.1007/s00192-009-0806-0.
Author information
Authors and Affiliations
Contributions
AF: Data collection, management, data analysis, and manuscript writing and editing. MG: Data collection, management. JCLM: Data collection, Management, manuscript writing. All authors have read and approved the final version of the article.
Corresponding author
Ethics declarations
Conflict of interest
The authors Alexandre Fornari, Marina Gressler, and Jean Carlos Levay Murari declare that they have no conflict of interest to declare about this study. They did not work or receive any benefit that can be linked with this study by the industry or other sponsor in the last five years. The study was supported by the authors.
Research Involving Human Participants and/or Animals
This study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. It was carried out at the Outpatient Micturition Disorders Clinic, Santa Casa de Misericórdia de Porto Alegre; Urology Department, Porto Alegre, RS, Brazil. Address: Prof. Annes Dias St, 135. Porto Alegre, Brazil. Zip code 90020-170. Phone + 55 51 3214 8000.
Ethics Committee Approval
This study was approved by the Santa Casa de Porto Alegre ethics committee number CAEE 15106913.0.00005335. According to the ethics committee, there is no need of informed consent due to the retrospective nature of the study, based only in medical records. All pictures received written consent to be published, kept by the corresponding author, and available if necessary. The ethical committee permission letter is available as PDF file in the supplementary material.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Alexandre Fornari is a urologist and head of Outpatient Micturition Disorders Clinic, Urology Department, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil. Marina Gressler is a staff urologist in Outpatient Micturition Disorders Clinic, Urology Department, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil. Jean Carlos Levay Murari is a staff urologist in Outpatient Micturition Disorders Clinic, Santa Casa de Misericórdia de Porto Alegre, and in Urology Department, Porto Alegre, RS, Brazil.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Fornari, A., Gressler, M. & Murari, J.C.L. Urethral Prolapse: A Case Series and Literature Review. J Obstet Gynecol India 70, 158–162 (2020). https://doi.org/10.1007/s13224-019-01288-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13224-019-01288-2