Thrombosed Urethral Prolapse in a Premenopausal Woman

Abstract

In Brief Background: Urethral prolapse is a rare condition and thrombosis is an infrequent complication of urethral prolapse. Urethral prolapse is seen almost exclusively in children and the elderly. Suspicion of urethral prolapse is essential for the correct diagnosis and prompt treatment of this condition. Treatment options include conservative and surgical management. Case: A premenopausal white woman was referred to urology for suspicion of a cancerous urethral mass. Physical examination was consistent with a necrotic thrombosed urethral prolapse. A combination of limited surgical excision and conservative therapy resulted in immediate postoperative pain relief and an excellent outcome. Conclusion: Thrombosed urethral prolapse is alarming to patients and healthcare providers. A circumferential urethral mass on physical examination should raise suspicion for urethral prolapse. Surgical management should be considered in patients with moderate to severe symptoms or large prolapsing masses prone to recurrence. Urethral prolapse is a rare condition in premenopausal adult women. The presentation, differential diagnosis, treatment options or urethral prolapse and the management of this unique case are discussed.