A rare case of urethral prolapse in a postmenopausal woman

Description

We present the case of a 74-year-old postmenopausal woman presenting with a 5-day history of dysuria, pain, urinary frequency and urethral bleeding. Her previous medical history included hypertension. Obstetric history included one forceps delivery and one normal vaginal delivery. On examination, an irreducible urethral prolapse was noted with bleeding urethral mucosa (figure 1).

Figure 1

Image revealing prolapsed urethral mucosa.

Patient went to theatre; another attempt was made to reduce the prolapse which was unsuccessful. Cystoscopy was then used to examine the urethra and bladder which revealed evidence of cystitis. With the cystoscope in situ, manual reduction was possible. A 20 French urethral catheter was inserted and the urethral wall was buttressed with suture to maintain reduction.

Patient was discharged with topical oestrogen cream and the catheter has since been removed without recurrence of prolapse.

Urethral prolapse is a very...

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