Anveden-Hertzberg L, Gauderer M W, Elder J S
Department of Surgery, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
Pediatr Emerg Care. 1995 Aug;11(4):212-4. doi: 10.1097/00006565-199508000-00004.
Urethral prolapse is an uncommon disorder in girls, usually presenting as "vaginal" bleeding. This retrospective chart review focuses on the high rate of misdiagnosis of urethral prolapse and describes treatment modalities based on 24 patients seen at a major children's hospital during an 11-year span. Their mean age was 4.9 years. The initial diagnosis, made by the referring pediatrician or emergency physician, was correct in only five girls (21%). Twenty children presented with urogenital bleeding. Operative correction was employed as initial treatment in 16 girls, with one recurrence. The remaining eight children were treated nonoperatively. Of these, five showed no improvement and underwent surgical repair. Although most children eventually require resection of the prolapsed urethral mucosa, nonoperative treatment is appropriate for asymptomatic girls with a mild degree of urethral prolapse. Increased physician awareness of urethral prolapse is desirable to enhance early recognition and to avoid unnecessary examinations and parental concern.
尿道脱垂在女童中是一种罕见疾病，通常表现为“阴道”出血。本回顾性病历审查聚焦于尿道脱垂的高误诊率，并描述了基于一家大型儿童医院在11年期间诊治的24例患儿的治疗方式。她们的平均年龄为4.9岁。由转诊的儿科医生或急诊医生做出的初步诊断，仅在5名女童（21%）中正确。20名儿童出现泌尿生殖系统出血。16名女童接受了手术矫正作为初始治疗，其中1例复发。其余8名儿童接受了非手术治疗。其中，5名无改善并接受了手术修复。尽管大多数儿童最终需要切除脱垂的尿道黏膜，但非手术治疗适用于无症状且尿道脱垂程度较轻的女童。提高医生对尿道脱垂的认识有助于早期识别，并避免不必要的检查和家长的担忧。
