Surgical Resection and Repair of Prolapse of the Urethral Mucosa in a Pubertal Girl: A Case Report

Background: Urethral mucosa prolapse, though a rare condition seen in pubertal/adolescence girls, diagnosis should be considered in cases of unexplained vaginal bleeding in this age group. This condition is most commonly observed in prepubertal black girls and postmenopausal white women however, it can be seen in pubertal and adolescence girls. The majority of cases (80%) are in the paediatric age group (between the ages of 6 months and 8 years) and the incidence in this age group is 1:3000. This case report presents a 12-year-old pubertal girl from Makurdi, Benue State, Nigeria, who presented with genital swelling and vaginal bleeding associated with pain. Due to the severity of her symptoms, surgical resection and repair (meatoplasty) were performed.

Case Presentation: The patient presented with genital swelling, vaginal bleeding, and pain. A genital examination revealed moderate vaginal bleeding and a dark red, oedematous mass with a central dimple prolapsing through the external urethral meatus. The diagnosis was confirmed by passing a pediatric nasogastric tube through the dimple, draining clear urine. She underwent a urethral meatoplasty and had an uneventful recovery.

Conclusion: Although urethral mucosa prolapse is rare in pubertal/adolescent girls, it is important for clinicians to consider this diagnosis in cases of unexplained vaginal bleeding. Surgical resection provides a definitive and cost-effective treatment, with excellent outcomes as demonstrated in this case.