Urethral Prolapse Management in Pediatric Populations
Summary
Urethral prolapse in children is a rare but clinically significant condition characterised by the circumferential eversion of the distal urethral mucosa through the external meatus. Predominantly affecting prepubertal girls, it often presents with genital bleeding, dysuria or a characteristic “doughnut-shaped” peri-meatal mass. Aetiological factors include low oestrogen levels, increased intra-abdominal pressure and intrinsic mucosal weakness. Accurate diagnosis relies on thorough clinical examination to differentiate prolapse from other causes of paediatric genital bleeding and to allay concerns of potential sexual abuse. Management ranges from topical medical therapies—such as oestrogen or corticosteroid creams combined with antibiotics—to surgical interventions that resect or ligate the prolapsed segment. Conservative approaches avoid the risks of anaesthesia but show variable success, prompting algorithms that reserve surgery for severe haemorrhage, vascular compromise or failed medical treatment. Long-term outcomes generally demonstrate low recurrence rates when treatment is tailored to prolapse severity and patient factors.
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Urethral Prolapse Management in Pediatric Populations publication trend
The graph below shows the total number of articles in urethral prolapse management in pediatric populations across all publications each year (not limited to Nature Index journals).
Technical terms
Urethral prolapse: Circumferential eversion of the distal urethral mucosa through the external meatus, forming a doughnut-shaped protrusion.
Conservative management: Non-surgical therapy employing topical creams (often oestrogens or corticosteroids) and antibiotics, aimed at reducing inflammation and oedema.
Surgical excision: Resection of prolapsed urethral mucosa followed by primary closure or re-anastomosis to restore normal anatomy.
Meatoplasty: Surgical reconstruction or enlargement of the urethral meatus after tissue excision to ensure patency and prevent recurrence.
References
- Conservative approach for the treatment of urethral prolapse in children: case report and literature review of 278 pediatric cases. African Journal of Urology (2021).
- Conservative management of urethral prolapse in African girls: a report of 15 cases. African Journal of Urology (2022).
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