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Presentation:
- Prepubertal females are especially susceptible to urethral prolapse
- Can present incidentally is a painless mass found during bathing or on exam
- More commonly presents as urogenital bleeding, dysuria, or (rarely) urinary retention
Evaluation:
- Appears as a partial or circumferential "donut" of bright red, often friable prolapsed mucosa
- Typically occurs in the setting of UTI, cough, or constipation
- Need to rule out complications: UTI, urethral necrosis, and urinary retention
Treatment:
- Medical management start with sitz baths twice daily and addressing causative factors (treatment constipation, UTI, etc.)
- Can add either topical corticosteroid (hydrocortisone) or estrogen (Estrace or Premarin 0.01% twice daily)
- Urology follow-up necessary as many will require surgical resection of prolapsed mucosa