Urethral prolapse, also known as urethrocele, occurs when the urethra protrudes from the urinary opening. This rare but non-life-threatening condition is most common among prepubescent girls.
What Happens During Urethral Prolapse
A urethral prolapse is characterized by a protrusion of the inner lining of the urethra from the urinary opening. The urethra is a tube that carries urine from the bladder to the front of the vagina. When prolapsed, the urethra appears as a large pink doughnut-like structure.
Symptoms of Urethral Prolapse
Most children with urethral prolapse are asymptomatic. However, some may notice blood spots on their underwear or diaper or experience tenderness when wiping. Postmenopausal women with urethral prolapse may have symptoms such as painful urination, frequent urination, blood in the urine, and increased nighttime urination. Rarely, it can cause pain during sexual intercourse.
Causes of Urethral Prolapse
The exact cause of urethral prolapse is unknown, but several risk factors include:
- Genetic predisposition
- Chronic cough
- Constipation
- Physical exertion
- Malnutrition
- Urinary tract infection (UTI)
- Being overweight or obese
- Trauma
Increased abdominal pressure and weak tissues around the urethra can contribute to the condition. Low estrogen levels before puberty are also associated with urethral prolapse. It is most common in prepubescent African American girls aged five to eight years. Women who have been pregnant and given birth are at higher risk due to the strain on the abdominal and pelvic regions, which can weaken the pelvic floor muscles and supporting tissues.
Diagnosing and Treating Urethral Prolapse
Urethral prolapse is often detected during routine physical exams. In adults, a cystourethroscopy may be used to confirm the diagnosis.
Treatment options may include:
1. Estrogen Cream: Applying estrogen cream two to three times a day for two weeks can strengthen supporting tissues and alleviate mild symptoms. Children on estrogen should be monitored for side effects like breast budding and pubic hair growth.
2. Petroleum jelly: Applying petroleum jelly can reduce sensitivity and tenderness by acting as a protective barrier.
3. Lifestyle Changes: Overweight or obese women should aim to lose weight and avoid heavy lifting to reduce recurrence risk.
4. Treating Constipation: Addressing constipation in children can prevent straining during bowel movements, aiding tissue healing.
5. Sitz Baths: Taking 15- to 20-minute baths twice daily can help heal the prolapse and maintain cleanliness.
6. Surgery: If conservative treatments are ineffective, surgery may be necessary to remove the protruding tissue and suture the lining. Post-surgery, catheterization is required for a short period.
Choose UCI Pelvic Health Center for Urethral Prolapse Treatment
If you or a loved one is experiencing symptoms of urethral prolapse, such as tenderness, frequent urination, or noticeable protrusion, UCI Pelvic Health Center is here to help. Our experienced team specializes in the accurate diagnosis and effective treatment of urethral prolapse.