Hidouri Saida, Ammar Sabrine Ben, Mosbahi Sana, Chaouch Mohamed Ali, Gafsi Besma, Mekki Mongi
Research Laboratory LR12SP13, Faculty of Medicine of Monastir, Tunisia; Department of Paediatric Surgery, Hospital of Zaghouan, Tunisia.
Department of Paediatric Surgery, Hospital of Zaghouan, Tunisia.
Int J Surg Case Rep. 2024 Jul;120:109879. doi: 10.1016/j.ijscr.2024.109879. Epub 2024 Jun 5.
Urethral Prolapse (UP), first described by Solinger in 1732, is a rare condition characterized by the circular protrusion of the distal urethral mucosa through the external meatus, forming a hemorrhagic, sensitive vulvar mass. This condition is most commonly observed in prepubertal black females. This case report details the clinical manifestations and surgical management of UP in three young girls.
Three girls, aged 4, 5, and 6 years, were admitted with symptoms of vaginal blood spotting. Physical examinations revealed moderate bleeding and a red ring of congested, edematous tissue prolapsing through the urethral meatus. Diagnostic procedures confirmed UP, and surgical management was undertaken. The surgical approach involved the complete excision of the prolapsed tissue and mucosal-to-mucosal anastomosis under general anaesthesia. Postoperative follow-up over a mean period of 11 years showed no recurrence or urethral stricture.
UP is a rare benign condition primarily affecting the female urethra, with several hypothesized etiologies, including weak pelvic floor structures and increased intraabdominal pressure. The typical presentation includes vaginal bleeding and a doughnut-shaped mass around the urethral meatus. Conservative management may be considered for mild cases, but surgical excision is recommended for severe cases, offering a safe and effective solution with low recurrence rates.
UP in children, although rare, should be considered in cases of unexplained vaginal bleeding. Diagnosis is primarily clinical, and surgical resection provides a definitive and cost-effective treatment.
尿道脱垂（UP）于1732年由索林格首次描述，是一种罕见病症，其特征为尿道远端黏膜经尿道口呈环形突出，形成一个出血性、敏感的外阴肿物。这种病症最常见于青春期前的黑人女性。本病例报告详细介绍了3名年轻女孩尿道脱垂的临床表现及手术治疗情况。
3名年龄分别为4岁、5岁和6岁的女孩因阴道点滴出血症状入院。体格检查发现有中度出血，且有一圈充血、水肿的组织经尿道口脱垂。诊断程序确诊为尿道脱垂，并进行了手术治疗。手术方法包括在全身麻醉下完整切除脱垂组织并进行黏膜对黏膜吻合。术后平均11年的随访显示无复发或尿道狭窄。
尿道脱垂是一种主要影响女性尿道的罕见良性病症，有多种病因假说，包括盆底结构薄弱和腹内压增加。典型表现包括阴道出血和尿道口周围呈甜甜圈状的肿物。轻度病例可考虑保守治疗，但重度病例建议手术切除，其提供了一种安全有效的解决方案且复发率低。
儿童尿道脱垂虽罕见，但在不明原因阴道出血的病例中应予以考虑。诊断主要依靠临床，手术切除提供了一种明确且具有成本效益的治疗方法。
