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一名8岁女童尿道脱垂酷似子宫脱垂:病例报告

Urethral prolapse mimicking a uterine prolapse in an eight-year-old girl: A case report.

作者信息

Muteke John Kasereka, Ahuka Albert Yemba Baruani, Sikakulya Franck Katembo

机构信息

University of Goma, Faculty of Medicine, Department of Obstetrics and Gynecology, Democratic Republic of the Congo; Regional Hospital of North-Kivu Province, Goma, Department of Obstetrics and gynecology, Democratic Republic of the Congo.

University of Goma, Faculty of Medicine, Department of Obstetrics and Gynecology, Democratic Republic of the Congo.

出版信息

Int J Surg Case Rep. 2022 May;94:107169. doi: 10.1016/j.ijscr.2022.107169. Epub 2022 May 6.

Abstract

INTRODUCTION AND IMPORTANCE

A urethral prolapse is a rare condition occurring most likely in prepubertal girls and post-menopausal women. The cause of this condition is not well known but an under-laying low level of estrogen is thought to have a role.

CASE PRESENTATION

This is an 8-year-old girl diagnosed with urethral prolapse, who was successfully managed by excision of the prolapsed urethral mucosa circumferentially. A three-month following up did not notice any particular challenge.

CLINICAL DISCUSSION

The most common presenting sign is genital bleeding and the vaginal doughnut sign. Treatment of urethral prolapse should begin with medical therapy in most patients before resorting to surgical management. However, in case of bigger size, severe genital hemorrhage, and prolapsed mucosa with an appearance suggestive of vascular compromise, surgical management is the first-line option. We estimate a severe prolapse mimicking a uterine prolapse must be included in surgical management as a first-line option.

CONCLUSION

Surgical excision may be the first-line option in certain urethral prolapses given its association with quick recovery versus the effectiveness of the long-time required for estrogen use, as well as the low likelihood of successful resolution linked to estrogen use.

摘要

引言与重要性

尿道脱垂是一种罕见病症,最常发生于青春期前女孩和绝经后女性。该病症的病因尚不清楚,但认为雌激素水平低下可能起到一定作用。

病例介绍

这是一名8岁被诊断为尿道脱垂的女孩,通过环形切除脱垂的尿道黏膜成功治愈。三个月的随访未发现任何特殊问题。

临床讨论

最常见的症状是生殖器出血和阴道甜甜圈征。大多数患者的尿道脱垂治疗应先采用药物治疗,然后再考虑手术治疗。然而,对于脱垂较大、严重生殖器出血以及脱垂黏膜外观提示有血管受损的情况,手术治疗是一线选择。我们认为,对于酷似子宫脱垂的严重脱垂,手术治疗应作为一线选择。

结论

鉴于手术切除与快速康复相关,而雌激素治疗需要较长时间且成功治愈的可能性较低,在某些尿道脱垂病例中手术切除可能是一线选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22eb/9118157/1828b8bff17c/gr1.jpg

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