Urethral Mucosal Prolapse in girls in Abidjan (Cote dIvoire)

Abstract

Dieth AG, Tembely S, Mieret JC, ToureA, Yaokreh JB Kouame YGS, Koffi M, Soro-Sounkerr M, Odehouri KT, Kouame DB, Ouattara O, da Silva-Anoma S, Dick KR

Objective: Urethral Mucosal Prolapse is a benign condition that is observed particularly in black girls. The benign nature of this disease contrasts with the anxiety of parents who attribute it to sexual abuse. This survey reported exclusively results of medical management of Urethral Mucosal Prolapse.

Patients and Methods: This retrospective study was conducted in CHU of Yopougon during 15 years from January 1998 to December 2012. All the patients in whom the surgical treatment was indicated at the outset of the disease were excluded from the study. The treatment consisted of the daily application of a dose of estrogen cream on the lump about the size of a hazelnut at the hypogastric region combined with a local antiseptic treatment as well as an antibiotic and a non-steroidal anti-inflammatory coverage.

Results: The patients were black Ivorian in 52 cases. They mean age was 4 years 8 months (1-11 years). In 87% of cases, genital hemorrhage was the telltale sign. In 36 patients the PMU was grade 4 (40.7%). The diagnosis was confirmed by clinical examination in all cases. Five cases were formally attributed to a rape. The total regression was observed before one month in 37 patients (68.5%). The average duration of treatment was 21 days (15-45 days). Two recurrences after early discontinuation of the hormonal treatment and 3 failures were identified; with a persisting residue of non-inflammatory ridge. The proposed surgical indication was rejected by parents in these 3 cases.

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