URETHRAL PROLAPSE - AN OFTEN MISDIAGNOSED CAUSE OF UROGENITAL BLEEDING IN GIRLS

Urethral prolapse is an uncommon disorder in girls, usually presenting as ''vaginal'' bleeding, This retrospective chart review focuses on t he high rate of misdiagnosis of urethral prolapse and describes treatm ent modalities based on 24 patients seen at a major children's hospita l during an Ii-year span, Their mean age was 4.9 years, The initial di agnosis, made by the referring pediatrician or emergency physician, wa s correct in only five girls (21%), Twenty children presented with uro genital bleeding, Operative correction was employed as initial treatme nt in 16 girls, with one recurrence. The remaining eight children were treated nonoperatively, Of these, five showed no improvement and unde rwent surgical repair, Although most children eventually require resec tion of the prolapsed urethral mucosa, nonoperative treatment is appro priate for asymptomatic girls with a mild degree of urethral prolapse, Increased physician awareness of urethral prolapse is desirable to en hance early recognition and to avoid unnecessary examinations and pare ntal concern.