A case report on urethral prolapse

Urethral prolapse is a rare and often underdiagnosed condition characterized by circumferential eversion of the distal urethra through the external urethral meatus, forming a doughnut-shaped protrusion. We present the case of a 34-month-old girl who was brought to the pediatric emergency unit by her parents following the discovery of bloodstains on her underwear. Clinical examination revealed a reddish, fleshy, doughnut-shaped mass measuring approximately 2.0 × 1.5 cm surrounding the urethral meatus, located above the vaginal introitus and beneath the clitoral hood. She was managed conservatively with oral cefixime suspension (4 mg/kg/day), ibuprofen, sitz baths, and topical estrogen cream. By the fourth day, the bleeding had completely resolved. The prolapsed mass was significantly reduced in size after two weeks and resolved entirely by the sixth week, without residual symptoms. This case highlights the importance of considering urethral prolapse as a differential diagnosis in cases with vaginal bleeding in prepubertal girls.