Urine retention caused by urethral prolapse mimicking uterine prolapse

Urethral prolapse is a rare clinical condition, which has been reported mostly in prepubertal girls; few menopaused and only 5 cases of premenopausal women. Strangulated urethral prolapse is even rarer.

A 64-year-old woman presented with urinary retention, painful vaginal bleeding and a protruding mass. Pelvic examination revealed a reddish doughnut-shaped mass located at introitus. The patient felt uncomfortable with attempts to reduce the presumed prolapse. Urethral prolapse was impressed and topical estrogen cream was prescribed. However, urethral mucosa became congested and without shrinkage three days later. As a result, simple excision was performed. No recurrence was noted at the time of manuscript submission.

Most common symptoms of urethral prolapse are vaginal bleeding and visible vaginal mass. Urethral prolapse can be diagnosed primarily by physical examinations. Surgical excision is a good way to treat recurrence or strangulated urethral prolapse with almost no complications and high success rate.