Hémorragie génitale de la petite fille : penser au prolapsus urétral

Ballouhey, Quentin; Abbo, Olivier; Sanson, S.; Cochet, Tiffany; Galinier, P.; Pienkowski, Catherine

doi:10.1016/j.gyobfe.2013.04.006

Cited by 7 publications

(6 citation statements)

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“…Clinical findings are classically made of a doughnutlike pinkish mass, surrounding the urethral orifice, which can be easily catheterized, and this was found in all of our patients as many other authors did [7,8,13,18,19]. With time, prolapsed mucosa gets ischemic, ulcerated, or necrotic [11,12].…”

Section: Discussionsupporting

confidence: 66%

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Conservative management of urethral prolapse in African girls: a report of 15 cases

et al. 2022

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Background Urethral prolapse is a rare disease, mainly occurring in African prepubertal girls. Its etiology remains unclear; however, some risk factors have been reported. The diagnosis is made clinically. The treatment can be conservative or surgical. Methods We report our experience in the service of pediatric surgery at Albert Royer National Children’s Hospital Centre. We conducted a retrospective descriptive cross-sectional study, on which considered patients were managed for urethral prolapse in our service from 2014 to 2019. Results Our study has included 15 girls whose mean age was 4.08 years (1.17–10). Two risk factors (chronic cough and constipation) were found in 20%. Genital hemorrhage was the main symptom (73.3%), and suspicion of sexual abuse was documented in 13.3%. The clinical finding was classical (donut-shaped vulvar mass) in all patients. All patients underwent conservative management, which was successful in 73.3%. Patients with failed conservative management were treated surgically by resection of the prolapsed mucosa on a Foley catheter. No complication was reported after surgical treatment, and after a 13-month mean follow-up, no recurrence was reported in all patients. Conclusions Conservative management is an efficient option for urethral prolapse. It has the advantage of avoiding general anesthesia with its potential complications and restricted availability in sub-Saharan Africa. Surgical management should be reserved for failed conservative management.

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Section: Discussionsupporting

confidence: 66%

“…Management of UP can be conservative or surgical. Several authors recommend conservative management as the first level of treatment, indicating surgery only in recurrent UP or failed conservative management of symptomatic UP [10,12,19]. Conservative management uses estrogen-based cream along with anti-inflammatory drugs and Sitz bath [11].…”

Section: Discussionmentioning

confidence: 99%

Conservative management of urethral prolapse in African girls: a report of 15 cases

et al. 2022

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“…Le prolapsus muqueux de l'urètre est une uropathie rare qui touche préférentiellement la fillette avant 5 ans (Ndour O et al 2017, Ballouhey et al 2013. Sa rareté est corroborée dans les diverses séries de la littérature (Falandry 1996).…”

Section: Discussionunclassified

“…Le diagnostic du prolapsus urétral repose sur l'examen clinique (Ballouhey et al 2013). L'hémorragie génitale représente le maître symptôme de la maladie.…”

Section: Discussionunclassified

Prolapsus Muqueux de L’urètre au Centre Hospitalo-Universitaire Départemental de Borgou -Parakou, Bénin

Armel

Rachid

Isidore

et al. 2021

ESJ

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Introduction: Le prolapsus muqueux de l’urètre est l’éversion circonférentielle de l’épithélium de la muqueuse urétrale congestive à travers le méat urinaire. L’objectif de cette étude était de rapporter la prise en charge des prolapsus muqueux de l’urètre. Méthodes: Il s’est agi de 7 dossiers de patientes prise en charge pour de prolapsus muqueux de l’urètre colligés rétrospectivement sur 4 ans dans le service de chirurgie du centre hospitalier universitaire départemental de Borgou à Parakou, au Nord du Bénin Résultats: L’âge moyen des patients, tous de sexe féminin, était de 4±0,8 ans avec des extrêmes de 2 ans et de 08 ans. Le principal motif de la consultation a été l’hémorragie génitale. A l’examen physique on retrouvait une tuméfaction sous-clitoridienne centrée par le méat urétral. La prise en charge a été chirurgicale. Nous avons procédé dans tous les cas en une excision de la muqueuse prolabée suivie d’une suture muco-muqueuse sur une sonde de Foley pour 48 heures. Les suites opératoires étaient simples et aucune récidive n'est observée après un recul moyen de 7 mois. Conclusion: Le prolapsus urétral est une affection rare qui se rencontre chez les fillettes prépubères. Le traitement chirurgical donne de résultats cliniques et esthétiques satisfaisants. Background: Mucosal prolapse of the urethra is the circumferential eversion of the epithelium of the congestive urethral mucosa across the urinary meatus. The objective of this study was to report our experience in the management of mucosal prolapse of the urethra. Methods: We reviewed 7 cases of patients treated for mucosal prolapse of the urethra, collected retrospectively over 4 years in the surgical department of the departmental university hospital of Borgou in Parakou, northern Benin. Results: The mean age of the patients, all female, was 4±0.8 years with extremes of 2 years and 08 years. The main reason for consultation was genital hemorrhage. Physical examination revealed a subclitoral swelling centered on the urethral meatus. The management was surgical. We proceeded in all cases with an excision of the prolapsed mucosa followed by a muco-mucosal suture on a Foley catheter for 48 hours. The postoperative course was simple and no recurrence was observed after a mean follow-up of 7 months. Conclusion: Urethral prolapse is a rare condition that occurs in prepubertal girls. The surgical treatment gives satisfactory clinical and aesthetic results.

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“…The exact incidence of UP is not well known, with a suggested incidence of one in 3000, and it occurs most often in prepubertal Black females and postmenopausal White women [2] , [3] , [4] . However, the rate of misdiagnosis is high because of the rare morbidity [5] , [6] . Vaginal bleeding is the most common presenting symptom of UP and a perineal mass is often evident.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of urethral prolapse in children: 16 years’ experience with 89 Chinese girls

Wei

Lin

et al. 2017

Arab Journal of Urology

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ObjectiveTo review our experience and results in the diagnosis and treatment of urethral prolapse (UP) in Chinese girls.Patients and methodsWe conducted a retrospective chart review of 89 consecutive girls (aged <16 years) with UP and without other complications, who received treatment for UP from January 1999 to January 2015 (a study period of 16 years) at the Children’s Hospital of Chongqing Medical University, China. Data analysed included: age, symptoms, clinical findings, predisposing factors, management, and outcomes.ResultsThe presenting symptoms in the 89 girls were: mass (54 girls), bleeding (34), and dysuria/straining at micturition (one). In all, 14 patients received conservative treatment as their symptoms were mild, and 75 were successfully treated by excision of the prolapsed urethral mucosa or ligation over a Foley catheter, as their symptoms were severe and recurred too frequently to be managed conservatively. The mean postoperative length of stay for ligation was 7.76 days and for excision was 4.57 days. Ligation over a Foley catheter had a longer hospital stay.ConclusionsUP is a rare condition occurring in prepubertal girls, evidenced by a urethral mass and bleeding. Increased physician awareness and early recognition of UP avoids unnecessary examinations and patient anxiety.

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Hémorragie génitale de la petite fille : penser au prolapsus urétral

Cited by 7 publications

References 6 publications

Conservative management of urethral prolapse in African girls: a report of 15 cases

Conservative management of urethral prolapse in African girls: a report of 15 cases

Prolapsus Muqueux de L’urètre au Centre Hospitalo-Universitaire Départemental de Borgou -Parakou, Bénin

Diagnosis and treatment of urethral prolapse in children: 16 years’ experience with 89 Chinese girls

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