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Updated: May 9, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Benefits of primary surgical resection for symptomatic urethral prolapse in children
Q Ballouhey1, P Galinier2, A Gryn3
1Service de chirurgie viscérale pédiatrique, Hôpital des Enfants, 8 avenue Dominique Larrey, 87042 Limoges Cedex, France.
Insights
Surgical resection is a safe and effective treatment for complicated urethral prolapse (UP) in children. While conservative management is recommended for uncomplicated cases, surgery offers a successful outcome for those with significant symptoms, with no recurrence observed.
Area of Science:
- Pediatric Urology
- Surgical Management
- Urethral Diseases
Background:
- Urethral prolapse (UP) involves the eversion of urethral mucosa, requiring differentiation from other conditions like trauma or tumors.
- Management strategies for UP are currently debated.
- This study focuses on promoting surgical intervention for UP.
Purpose of the Study:
- To evaluate the benefits of primary surgical management for urethral prolapse (UP) in pediatric patients.
- To assess the safety and efficacy of surgical resection for complicated UP.
- To highlight the importance of early detection and appropriate treatment strategies.
Main Methods:
- A retrospective multicenter review was conducted on 19 pediatric patients who underwent surgery for complicated urethral prolapse (UP) between 1991 and 2011.
- Conservative management was the primary approach for non-complicated UP.
- Surgical resection of the prolapsed urethral mucosa was performed for complicated cases.
Main Results:
- The average delay in diagnosis was 2.2 days, with vaginal spotting and bleeding being the most common symptoms.
- While no specific predisposing factors were identified, most patients were above the 50th percentile for weight, height, and BMI.
- All surgical procedures were successful, with only one case of dysuria reported as a complication. No recurrences were noted after a mean follow-up of 28 months.
Conclusions:
- Early detection of urethral prolapse (UP) relies on clinical examination.
- Conservative management is the recommended first-line treatment for uncomplicated UP.
- Surgical resection is a safe and effective option for pediatric patients experiencing significant symptoms associated with UP.
Objective:
Urethral prolapse (UP) is a complete eversion of the distal urethral mucosa through the external meatus. UP must be distinguished by examination from trauma, prolapsed ureterocele, tumors or sexual abuse. Its management remains controversial. The aim of the study was to promote the benefits of primary surgical management for UP.
Methods:
A retrospective multicenter review of children who received surgery for UP between 1991 and 2011 was carried out. Non-complicated UP was primarily treated conservatively. A total of 19 patients were referred for complicated UP and underwent resection of the prolapsed urethral mucosa.
Results:
The mean delay in diagnosis was 2.2 days (range 1-6) and the most common symptoms were vaginal spotting and bleeding. No predisposing factor was found, but most patients had a mean weight, height and BMI greater than the 50th percentile. All patients underwent surgery successfully. One patient experienced a complication, i.e., dysuria. There was no case of recurrence after a mean 28 months of follow-up.
Conclusion:
Early detection is based on bedside examination. The first-line treatment strategy for uncomplicated UP should be conservative management. Surgical resection is safe and effective for patients with significant symptoms.
