What Is a Urethral Prolapse?
Urethral mucosal prolapse, also known as urethral mucosal eversion, refers to a female urethral disease that occurs when the urethral mucosa and submucosal tissue prolapse and valgus outside the urethral orifice. It is relatively rare, mostly occurring in children and elderly women, followed by menopausal women.
Basic Information
- nickname
- Urethral mucosal eversion
- English name
- prolapse of urethra
- Visiting department
- Pediatrics, urology
- Multiple groups
- Children and older women
- Common locations
- Urethra
- Contagious
- no
Causes of urethral mucosal prolapse
- Child patient
- Because urethral mucosal prolapse in children is seen in weak girls, it is generally believed that the occurrence of this disorder is related to the rapid increase of the pelvis and changes in pelvic organs. If the urogenital diaphragm is weak, the congenital defect of urethral mucosa and submucosal adhesions , More prone to mucosal prolapse.
- 2. Older women
- Prolapse of the urethral mucosa may be due to childbirth damage, decreased estrogen levels after menopause, weakening of the urethral wall due to atrophy of the tissue around the urethra, or general weakness, etc., and relaxation of the tissue around the urethra causes the urethral mucosa to roll out.
- 3. Other
- Such as severe cough, constipation, diarrhea, childbirth, urinary tract infection, weight-bearing and so on make the bladder pressure too high, resulting in imbalance of bladder and urethral pressure, coupled with insufficient support tissue strength around the urethra, can also cause the disease.
- Other direct compressions such as bladder stones, urethral stones, or tumors can also be induced.
Clinical manifestations of urethral mucosa prolapse
- It appears as a mass at the mouth of the urethra. The part of the prolapse is located at the back of the urethra. The mucosa of the person with complete prolapse is prolapsed in a ring shape. The mouth of the urethra is located at the center of the mass. The diameter of the mass is 1 to 5 cm. The color changed from bright red to dark red or even blue-purple, often accompanied by serous bloody exudate.
- 1. Frequent urination and urgency
- Mild people often have local burning sensations and urinary tract irritation symptoms such as frequent urination and dysuria and urination pain, similar to the symptoms of urethral caruncle.
- 2. Urethral bleeding
- After the activity, bleeding was found at the urethral mouth, the amount was more or less.
- 3. urethral mass
- It can be seen that the ring-shaped or semi-ring-shaped purple-red mass comes out, the urethral orifice is located in the center of the mass, and the urine is inserted when the catheter is inserted. Severe cases may also be accompanied by infection, erosion, flaky necrosis or pus adhesion, bloody serous secretions, and odor. Due to thrombosis and tissue necrosis, severe pain is caused.
Examination of urethral mucosa
- Routine urine test
- May have increased white blood cell and red blood cell counts.
- Blood routine
- There may be an increase in white blood cell count.
- 3. Urine bacterial culture
- If a urethral infection is suspected, urethral secretions can be smeared or examined for bacterial culture to identify pathogenic bacteria. A positive result indicates an infection.
Diagnosis of urethral mucosa prolapse
- A clear diagnosis can be made based on clinical manifestations and related examinations.
Treatment of urethral mucosa prolapse
- Conservative treatment
- For young children, most of them can heal themselves. Therefore, these children are mainly treated by non-surgical treatment.
For premenstrual girls and those with mild mucosal prolapse, conservative treatment can be used first. Antibiotics can be used, topical application of estrogen ointment and hot water bath.
Menopausal women can take estrogen orally and reset prolapse in parallel.
- 2. Surgical treatment
- It is suitable for those who have failed conservative treatment and have obvious mucosal prolapse, especially those with incarcerated prolapse. Adults with incomplete prolapse can use injection therapy, while the treatment of complete prolapse is mainly surgery, but there are many postoperative complications.
- (1) Circular resection is the most commonly used surgical method. However, care should be taken not to pull the urethral mucosa outwards during resection to avoid excessive resection.
- (2) Cerclage is rarely used. A urethral catheter is built into the urethra. The basal part of the mucosa is tied with a No. 4 silk thread to the urethral catheter to let it necrosis and fall off.
- 3. Radial Electrocoagulation
- Radiation electrocoagulation was performed around the prolapsed mucosa, once every two weeks, and then retracted due to fibrosis several times.
Whether it is a young child or an adult patient, as soon as the mucosa prolapses, it should be immediately reset. If the prolapse time is long, the prolapsed tissue is congested and the edema is serious, you should go to the hospital for treatment, and ask the doctor to reset as much as possible.