Reduction Of Strangulated Urethral Prolapse Using Local Anesthesia With Hyaluronidase

Abstract

We report a case of urethral prolapse that was successfully managed by an innovative technique using manual reduction performed with the patient under local anesthesia induced by hyaluronidase injection. CASE REPORT A 59-year-old Chinese woman presented with dysuria and frequency 1 day in duration. Physical examination revealed an erythematous mass completely surrounding the urethral meatus (fig. 1). Urethral prolapse was diagnosed. The prolapsed mucosa measured about 1 cm. in length. Attempted manual reduction was unsuccessful. Intralesional injection of 1,500 IU hyaluronidase and 2 ml. 2% lidocaine (total 4 mL.) was administered circumferentially. Manual reduction was then performed without difficulty (fig. 2). A 14Fr Foley catheter was subsequently placed and left indwelling for 3 days. Dysuria and frequency resolved after removal of the catheter. The patient had suffered no recurrence at 1-year followup.