Urethral Prolapse in Prepubertal Girls in Port Harcourt, Nigeria: A Multicentre Study

Background: Urethral mucosa prolapse is a rare condition mainly seen in prepubertal girl with racial predilection for black girls. Methodology: This was a multicenter 7-year retrospective analysis of 27 cases of urethral mucosa prolapse treated at the university of Port Harcourt teaching hospital and private health facilities in Port Harcourt from 2011-2018. Relevant information extracted from the case files include age, clinical presentation, examination findings, treatment modality and post-operative complications. Data was entered and analyse using SPSS version 25 and results were presented in simple percentages and frequency tables Results: The institutional prevalence of urethral prolapse was 0.14%. The commonest presenting complaint was blood stains on the underwear in 23 (85.2%) patients while all patients presented with the characteristic ‘doughnut sign’ of a circumscribed fleshy mass surrounding the urethral meatus. All patients had intact hymen. Surgery was the primary treatment modality in 24 (88.9%) cases while conservative medical management was carried out in three (11.1%) patients. The success rate for surgical management was 100% and 33.3% for medical treatment. The commonest post-operative complication was dysuria reported in 7 (25.9%) cases and acute urinary retention was reported in one (3.75) patient. Conclusion: Urethral mucosa prolapse is a rare but important condition in prepubertal girls presenting with vaginal bleeding due to the suspicion of sexual abuse. Surgical treatment offers better outcome amongst the studied population.