Title: Urethral prolapse in prepubertal females (submitted by Megan Kirk, MD)<br/>Author: Mimi Lu<br/><a href='http://umem.org/profiles/faculty/185/'>[Click to email author]</a><hr/><p>
        <span>Presentation</span>:</p>
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        <span>- Prepubertal females are especially susceptible to urethral prolapse</span><span> </span></p>
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        <span>- Can present incidentally is a painless mass found during bathing or on exam </span></p>
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        <span>- More commonly presents as urogenital bleeding</span>, <span>dysuria</span><span>, or (rarely) urinary retention</span></p>
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        Evaluation:</p>
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        <span>- Appears as a partial or circumferential "donut" of bright red, often friable prolapsed <span>mucosa</span></span></p>
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        <span>- Typically <span>occurs in the setting of UTI, cough, or constipation</span></span></p>
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        <span>-<span> Need to rule out complications: UTI, urethral necrosis, and urinary retention </span></span></p>
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        <span>Treatment:</span></p>
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        -<span> Medical management start with sitz baths twice daily and addressing causative factors (treatment constipation, UTI, etc.)</span></p>
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        -<span> Can add either topical corticosteroid (hydrocortisone) or estrogen</span><span> (Estrace or Premarin 0.01% twice daily)</span></p>
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        - <span>Urology follow-up necessary as many will require surgical resection of prolapsed mucosa</span></p>