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Concomitant urethral and uterovaginal prolapse in a postmenopausal woman. A case report
Michael E Carley1, Christopher J Klingele, Kristi L Boldt
1Department of Obstetrics and Gynecology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Background:
Urethral prolapse is frequently encountered in girls. Although its occurrence in elderly women is not rare, little published information exists regarding this clinical condition or its management.
Case:
A 90-year-old woman (gravida 1, para 1) with a four-year history of intermittent vaginal bleeding had both urethral and uterovaginal prolapse. The condition was initially managed conservatively with estrogen and a pessary. Ultimately, surgical intervention was required for complete resolution.
Conclusion:
Urethral prolapse can occur in elderly women and may present concomitantly with other forms of pelvic floor dysfunction such as uterovaginal prolapse. Conservative treatment with estrogen is partially effective in reducing the size of the urethral prolapse and may point to hypoestrogenism as one potential cause of this condition in elderly women. However, surgical management may ultimately be required for complete resolution of these problems, even in medically compromised patients.