Adolescent Urethral Prolapse Complicated by Suspected Secondary Infection in a Girl With Autism Spectrum Disorder: A...

Urethral prolapse (UP) is an uncommon condition that typically affects prepubertal girls and postmenopausal women, with adolescent cases rarely reported. We describe an 18-year-old girl with autism spectrum disorder and chronic diarrhea who presented with genital bleeding and a circumferential mass arising from the external urethral meatus. Marked leukocytosis (22 030/μL), neutrophilia, and elevated C-reactive protein levels indicated a systemic inflammatory response, although urine culture yielded only normal flora. Cystoscopy confirmed UP without intravesical lesions. The patient was treated with bladder drainage and intravenous piperacillin-tazobactam, leading to normalization of inflammatory markers; however, the prolapse persisted and required surgical excision. Postoperatively, she experienced complete symptom resolution, including disappearance of prolonged toilet use. This case illustrates the importance of considering UP in adolescents presenting with vulvar masses and highlights how hygiene-related factors and voiding patterns may contribute to complications such as suspected secondary infection or severe local inflammation. Surgical excision was safe and effective.