UMEM Educational Pearls

Category: Pediatrics

Title: Prepubertal Urethral Prolapse

Keywords: prepubertal vaginal bleeding, mass (PubMed Search)

Posted: 9/18/2020 by Jenny Guyther, MD (Updated: 10/20/2020)
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- Urethral prolapse will appear as a protrusion of the distal urethra through the urinary meatus causing a “doughnut” sign.

- Risk factors include trauma, UTI, anatomical differences, and increased intraabdoiminal pressure from cough or constipation.  There is a higher incidence in people of African descent.

- The chief complaint may include urethral mass and vaginal bleeding.

- There is a bimodal age distribution (prepuberty and postmetapause) due to a relative estrogen deficiency.

-Treatment is with estrogen cream and sitz baths for 4- 6 weeks.

References

McCaskill A, Inabinet C, Tomlin K et al.  Prepubertal Genital Bleeding: Examination and Differential Diagnosis in Pediatric Female Patients.  The Journal of Emergency Medicine 2018; 55(4): 97-100.