Congenital urethral polyps in girls: as a differential diagnosis of interlabial masses

Abstract

Study objective: To present the clinical appearance, differential diagnosis, long-term follow-up, and the surgical result of single-center experience with female urethral polyps presenting as an interlabial mass, and to report the common causes of interlabial masses in infants.

Design: All 12 girls who presented with an interlabial mass and intermittent bleeding have been included in this study; however, the benign urethral polyps are discussed in detail and are the subject of this study.

Setting: All patients were referred to our national referral pediatric urology center with initial impression of vaginal bleeding; however, rhabdomyosarcoma of bladder and urethra (n = 2) or vagina (n = 3) and urethral polyp (n = 7) was the final diagnosis.

Participants: The records of 12 girls who presented with external genitalia bleeding were retrospectively reviewed. Among them, 7 had fibroepithelial polyps and underwent initial polypectomy between 2001 and 2011with mean age of 21.5 months (range: 1-90 mo). All girls underwent endoscopic surgical removal of polyps.

Main outcome measures: No postoperative polyp recurrence was observed following endoscopic polyp resection.

Results: The postoperative period was uneventful except in 1 girl who had immediate postoperative urethral bleeding which stopped spontaneously. There was no major complication or polyp recurrence after operation during the long-term follow-up.

Conclusions: The interlabial mass must be considered as a urethral polyp and should be differentiated from the vaginal rhabdomyosarcoma with protrusion of vaginal tumor from the vaginal outlet or other benign lesions. Physical examination in frog legged position or examination under anesthesia with urethrocystoscopy may confirm the final diagnosis.

Keywords: Congenital; Female; Fibroepithelial; Interlabial; Polyps; Urethra; Vagina.