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Urethral prolapse in Adult
Other Resources UpToDate PubMed

Urethral prolapse in Adult

Contributors: Mitchell Linder MD, Manasi Kadam Ladrigan MD, Amy Swerdlin MD
Other Resources UpToDate PubMed


Urethral prolapse is an uncommon condition most often seen in prepubertal girls of African descent and in postmenopausal women of Northern European descent. Incidence is thought to be about 1 in 3000. Predisposing factors include persistent cough, constipation / straining with bowel movements, and trauma.

Before puberty, the estrogen-dependent tissues supporting the distal urethra are weak and atrophic. Prolapse may occur with any activity that results in an increase in abdominal pressure such as coughing or straining to defecate. Spontaneous prolapse is also possible.

After menopause, loss of estrogen may be a contributing risk factor.

Urethral prolapse often presents as bleeding with a polypoid or donut-shaped, edematous, violaceous, and nontender mass present at the urethral opening. The exposed mucosa is very friable, often leading to misdiagnosis as trauma. The friable and often excoriated tissue may be complicated by ulceration and infection. Pain is typically absent, but girls may have symptoms of dysuria and urinary frequency due to associated edema. This prolapse also can be an incidental finding during a routine examination.

Patients should be questioned about sexual abuse as part of a thorough assessment of genital abnormality, although there is not a known association between child sexual abuse and urethral prolapse.


N36.8 – Other specified disorders of urethra

12068006 – Prolapse of urethra

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Urethral caruncle
  • Ureterocele
  • Genital wart
  • Rhabdomyosarcoma
  • Sarcoma botryoides
In pediatric patients, also consider:
  • Child sexual abuse
  • Infantile hemangioma

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Last Reviewed:10/04/2018
Last Updated:01/15/2020
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Urethral prolapse in Adult
A medical illustration showing key findings of Urethral prolapse : Female genital, Genital edema, Urethra, Urinary frequency, Vaginal bleeding, Dysuria
Copyright © 2024 VisualDx®. All rights reserved.