Urethral prolapse in Tanzanian prepubertal girls. An experience from Mbeya Zonal Referral Hospital (MZRH) and Mzinga Military Hospital in Morogoro, Tanzania

Abstract

Objective: We report case series of urethral prolapse to the gynecology and urology fraternity so as to continue raising awareness in the early diagnosis and ultimate medical treatment first before surgical intervention is deployed.
Settings: This case series includes one patient from Mzinga Military hospital in Morogoro and two cases from Mbeya zonal Referral hospital in southern Highland of Tanzania. Subjects; Three cases of premenarche girls of seven years, four years and three years old.
Intervention: Topical estrogen was initiated to these patients for the period of two weeks.
Outcome: We observed a quick response to treatment and resolution of symptoms within two weeks of treatment.
Results: Urethral prolapse is a rare condition occurring to young girls and postmenopausal women. In the literature there has been evolution in the management of this rare condition however many studies advocate surgical intervention.
Conclusion: Urethral prolapse in young premenarche girls is uncommon and it is often misdiagnosed. Treatment can be medical or surgical intervention. The patients presented here were able to respond to topical estrogen for two weeks. Follow up has been for three months with no recurrence. Therefore, this case series is expected to raise more awareness to the clinicians about urethral prolapse in young girls so as to be able to increase the index of suspicion in the early diagnosis in prepubertal girls who presents with vaginal bleeding, vaginal/urethral mass but also to prompt be in a position to treat this condition medically as recommended in this series.