Strangulated urethral prolapse in a postmenopausal woman presenting as acute urinary retention

A rare case of a necrotized urethral prolapse in a postmenopausal woman with acute urinary retention

“…As a result of this, it may be strangulated and necrotized making a manual reduction painful or even impossible. 4 The conservative management was presented by Ko et al, who described an intralesional injection of hyaluronidase and 2% lignocaine followed by manual reduction of the prolapse. However, the patient still had to undergo an excision 3 weeks later because of recurrence.…”

“…15 The total removal of the prolapsed urethral mucosa and anastomosis of the remaining urethral wall to the vestibule margin were considered as a standard treatment in previous studies. 4 Some urologists remove the catheter immediately postoperatively and others after 3 to 5 days. In our case, the patient needed continued care in another surgical unit because of cholestasis, and therefore she had the catheter for 11 days.…”

“…3 The etiology is still unknown, but lack of estrogen and hypermobility in the perineum have previously been described as possible underlying factors. 4 Another theory was put forward by Lowe et al, claiming that UP occurs because of a cleavage plane between the outer circular and the inner longitudinal smooth muscle layers in the urethra together with increasing intra-abdominal pressure. 5 UP occurs when the distal urethral mucosa emerges through the external meatus and creates a circular protrusion.…”

“…Surgical management through a circumferential excision of prolapsed urethral mucosa has previously been described. 4 Herein, we present a case of UP in a postmenopausal woman who presented with acute urinary retention (AUR).…”