Urethral Prolapse: A Case Series and Literature Review

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.

Keywords: Prolapse treatment; Urethral caruncle; Urethral mass; Urethral prolapse; Urological surgery; Vaginal bleeding.

Fig. 1

a Case number 12, b case number 6: reproductive-aged patient with a small urethral mucosal prolapse, c, d highly symptomatic small partial urethral mucosal eversion in two reproductive-aged patients

Fig. 2

a Case number 1, b case number 3, c case number 10, d case number 9 at the start of surgery

Fig. 3

All images are from case 11. a Before surgery, b prolapse reduced in the emergency room, c two-month postoperative follow-up after topical estrogen replacement, d three years after surgery, a urethral caruncle developed