1 Background
2 Materials and methods
3 Results
3.1 Case presentation
4 Review of the literature
Source | Baseline characteristics | Clinical findings | |||||
---|---|---|---|---|---|---|---|
Number of patients (gender) | Age | Ethnicity (skin color) | Reason for referral | Other symptoms | Medical history | Prolapse description | |
Zhang et al. (2020/China) [7] | n = 8 All females | [1 month–10 years] | NR | Vaginal bleeding = 8 | NR | NR | NR |
Novoa-Carballal et al. (2018/Spain) [20] | n = 1 All females | 8 y.o | (White) = 1 | Vaginal bleeding = 1 | Itching | NR | Painless red, friable circular mass occupying the central part of the vulva introitus |
McCaskill et al. (2018/USA) [4] | n = 1 All females | 6 y.o | (White) = 1 | Vaginal bleeding = 1 | Urinary frequency Urinary urgency Dysuria constipation Abdominal pain | No remarkable history | 2 cm in diameter, tender, irregularly shaped, friable, exuberant, and erythematous with dark purple-colored peripheral margins |
Wei et al. (2017/China) [3] | n = 89 All females | [0.92–12.7] y.o | NR | Vaginal mass = 54 Vaginal bleeding = 34 Dysuria = 1 | NR | Malnutrition = 29 Urinary tract infection = 9 Cough = 17 Vulvitis = 5 Diarrhoea = 7 Constipation = 3 | A 0.5–3 cm lump protruding from the urethra with clearly visible central urethral opening |
Liu et al. (2017/China) [6] | n = 7 All females | [2–8] y.o | NR | Vaginal bleeding + mass = 7 | Hematuria = 1 Urodynia = 1 | Respiratory infection = 4 History of trauma = 1 | A mass protruding out of the vaginal opening |
Lora et al. (2017/Italy) [14] | n = 1 All females | 8 y.o | Caucasian (white) = 1 | Vaginal bleeding = 1 | NR | Constipation = 1 | Red ‘doughnut’-shaped lesion surrounding the urethral meatus |
Kondamudi et al. (2014/USA) [19] | n = 1 All females | 6 y.o | African American (black) = 1 | Vaginal bleeding = 1 | NR | No remarkable history | A round doughnut-shaped reddish-colored mass protruding from the urethral opening |
Ballouhey et al. (2014/France) [1] | n = 28 All females | [3–9] y.o | (Black) = 17 NR = 11 | Vaginal bleeding = 17 Urinary symptoms = 2 Vaginal pain = 6 Not reported = 3 | NR | Chronic constipation = 2 Chronic cough = 2 Cerebral palsy = 1 Urinary tract infections = 3 Upper respiratory illness = 3 | An inflamed and friable mass that closed the vaginal opening was observed; the urethral orifice was found in its center |
Ballouhey et al. (2013/France) [15] | n = 1 All females | 5 y.o | NR | Vaginal bleeding = 1 | NR | No remarkable history | 2 cm urethral protrusion with ulceration and blood clots |
Holbrook et al. (2011/UK) [8] | n = 21 All females | [2–15] y.o | (Black) = 21 | Urethral mass = 8 Vaginal bleeding = 6 Dysuria = 6 Leucchorea = 1 Constipation = 1 | NR | NR | All had 0.5–2 cm urethral lump with clearly visible central opening = 21 Blue coloration = 3 |
Aprile et al. (2011/Italy) [2] | n = 1 All females | 6 y.o | Caucasian (white) = 1 | Vaginal bleeding = 1 Sexual abuse = 1 | NR | Trauma (fall) = 1 | Red mucous membrane prolapsed form the urethra |
Fiogbe et al. (2011/Benin) [12] | n = 9 All females | [2.5—10] y.o | NR | Vaginal bleeding = 5 Vaginal mass = 2 Dysuria = 2 | NR | No remarkable history | 0.75 to 1 cm ring-shaped congested, oedematous, non-tender mass |
Vunda et al. (2011/Switzerland) [16] | n = 1 All females | 2.5 y.o | (Black) = 1 | Vaginal bleeding = 1 Sexual abuse = 1 | NR | No remarkable history | 0.5-cm circumferential prolapsed mass |
Pereira et al. (2011/UK) [17] | n = 1 All females | 5 y.o | (Black) = 1 | Vaginal bleeding = 1 | NR | No remarkable history | Congested, friable, purplish red doughnut-shaped mucosal mass |
Ekenze et al. (2009/Nigeria) [10] | n = 3 All females | [3–5] y.o | NR | NR | NR | NR | NR |
Hillyer et al. (2009/USA) [5] | n = 34 All females | [5 months–12 years] | (Black) = 34 | Vaginal bleeding = 34 | Dysuria = 10 | Trauma (fall) = 3 Sexual abuse, STDs = 1 Trauma (pelvic) = 1 Preterm delivery = 4 Asthma = 7 Upper respiratory illness = 5 Hernia = 2 Pneumonia = 1 Mitral regurgitation = 1 stomach cramps = 1 | Protruding, congested, and edematous bleeding, fleshy mass surrounding the external urethral meatus |
Agarwal et al. (2008/UK) [9] | n = 2 All females | (4, 4.5) y.o | Afro-Caribbean (black) = 2 | Vaginal bleeding = 2 | NR | No remarkable history | Typical ‘‘doughnut’’ appearance of urethral prolapse |
Shurtleff et al. (2002/USA) [13] | n = 3 All females | [3, 6, 8] y.o | NR | Vaginal bleeding = 3 Sexual abuse = 1 | Moderate pain = 3 Dysuria = 1 | No remarkable history | Ring of congested, edematous tissue prolapsing through the urethral meatus |
Silva-Anoma et al. (2001/Ivory Cost) [11] | n = 65 All females | [6 weeks–14 years] | African (Black) = 65 | Vaginal bleeding = 29 Hematuria = 5 Urethral mass = 1 Sexual abuse = 5 Vaginal mass = 4 Urethral Prolapsus = 7 Genital malformation = 2 Labia minora hypertrophy = 2 Leucchorea = 4 Trauma = 2 Not precise = 4 | Asymptomatic = 13 | NR | Circular eversion under the clitoris |
McKenna et al. (1999/Queensland) [18] | n = 1 All females | 7 y.o | Caucasian (white) = 1 | Vaginal bleeding = 1 | NR | Mild asthma = 1 | 1.5 cm fleshy, mulberry like lesion with intact hymen = 1 |
Source | Participants No. | Non-surgical treatment | Surgical treatment | ||||||
---|---|---|---|---|---|---|---|---|---|
Type of treatment | Indication | Outcome | Follow-up duration | Type of treatment | Indication | Outcome | Follow-up duration | ||
Zhang et al. (2020/China) [7] | n = 8 | Conservative treatment = 7 (no details) | First line = 7 | Successful = 7 | NR | Surgical resection = 1 | First line = 1 | Successful = 1 | NR |
Novoa-Carballal et al. (2018/Spain) [20] | n = 1 | Conservative treatment = 1 (no details) | First line = 1 | Successful with mild prolapse = 1 | NR | None | None | None | None |
McCaskill et al. (2018/USA) [4] | n = 1 | TEC = 1 | First line = 1 | Successful = 1 | 1 m | None | None | None | None |
Wei et al. (2017/China) [3] | n = 89 | Sitz baths + local ATB + steroids antispasmodic + urinary tract decontamination + manipulative reduction = 89 | First line = 89 | Successful = 14 unsuccessful = 75 (treated surgically) | 1–16 y | Surgical excision = 20 Ligation over Foley catheter = 55 | Failure of conservative treatment = 75 | Successful = 75 | 1–16 y |
Liu et al. (2017/China) [6] | n = 7 | antiinflammation therapy + perineum nursing + sitz bath + Cath = 2 | First line = 2 | Successful = 2 | 6 y | Catheter + Loop excision + Suturing with Vicryl 6/0 sutures + Local gauze packing = 5 | First line = 5 | Successful = 5 | 2 w—5 y |
Lora et al. (2017/Italy) [14] | n = 1 | TEC + oral polyethylene glycol for constipation = 1 | First line = 1 | Unsuccessful = 1 (referred to urologist) | 10 m | None | None | None | None |
Kondamudi et al. (2014/USA) [19] | n = 1 | TEC = 1 | First line = 1 | NR | NR | None | None | None | None |
Ballouhey et al. (2014/France) [1] | n = 28 | sitz baths + anti-inflammatories = 14 | First line = 14 | Successful = 9 Unsuccessful = 5 (treated surgically) | 1–52 m | Catheter + 6 holding sutures + 4 stay & temporary holding sutures in each quadrant + resection with cautery + intervening tissue sutured with two stitches. = 19 | First line = 14 Failure of conservative treatment = 5 | Successful = 19 | 1–52 m |
Ballouhey et al. (2013/France) [15] | n = 1 | sitz bath + local steroids for 3 days = 1 | First line = 1 | Unsuccessful = 1 (treated surgically) | 6 m | Resection by electrocoagulation around a Foley-type probe + suture with separate points = 1 | Failure of conservative treatment = 1 | Successful = 1 | 6 m |
Holbrook et al. (2011/UK) [8] | n = 21 | Sitz bath = 13 | First line = 13 | Successful = 13 | NR | Reduction under a general anaesthetic = 8 | First line = 8 | Successful = 3 Recurrence = 1 Partial reduction = 2 Minimal residual prolapse = 2 | NR |
Aprile et al. (2011/Italy) [2] | n = 1 | Rest = 1 | First line = 1 | Successful = 1 (recurred after 2 y) | 2 y | Surgical excision | Recurrence = 1 | NR | NR |
Fiogbe et al. (2011/Benin) [12] | n = 9 | Povidone iodine + Prophylactic ATB + anti-inflammatories = 3 | First line = 3 | Successful = 3 | 10 d | Foley’s urethra catheter + circumferential resection + muco-mucous suture = 6 | First line = 6 | Recurrence = 1 (treated again) Successful = 5 | 20 m |
Vunda et al. (2011/Switzerland) [16] | n = 1 | TEC (promestriene) + sitz baths + camomile = 1 | First line = 1 | Successful = 1 | 6 w + 20 m | None | None | None | None |
Pereira et al. (2011/UK) [17] | n = 1 | TEC, Sitz bath = 1 | First line = 1 | Unsuccessful = 1 (referred to urologists) | 4 w | None | None | None | None |
Ekenze wt al. (2009/Nigeria) [10] | n = 3 | TEC = 3 | First line = 3 | Unsuccessful = 3 (treated surgically) | 6–17 m | Excision + seromucosal stitching = 3 | Failure of medical treatment = 3 | Successful = 3 | NR |
Hillyer et al. (2009/USA) [5] | n = 34 | TEC, Sitz bath = 6 | First line = 6 | Loss of follow-up = 4 unsuccessful = 2 (treated surgically) | NR | Foley’s urethra catheter + circumferential resection + catgut sutures = 30 | Failure of medical treatment = 2 First line = 28 | Successful = 30 | 1 m |
Agarwal et al. (2008/UK) [9] | n = 2 | Manual reduction + Cath = 1 | First line = 1 | NR | NR | Four-quadrant excision = 1 (another case) | First line = 1 | NR | NR |
Shurtleff et al. (2002/USA) [13] | n = 3 | Sitz bath = 3 | First line = 3 | Unsuccessful = 3 (treated surgically) | 7 d | Four-quadrant excision = 3 | Failure of medical treatment = 3 | Successful = 3 | 2 w 8 m—2 y |
Silva-Anoma et al. (2001/Ivory Cost) [11] | n = 65 | Amoxicilline, Metronidazol + Morniflumate + Polyvidone iode = 12 | First line = 12 | Successful = 3 NR = 9 | 1 y | Doria technique = 38 Cath + excision + sutures = 15 | First line = 53 | Successful = 53 | 1 y |
McKenna et al. (1999/Queensland) (18) | n = 1 | TEC and steroid cream = 1 | First line = 1 | Unsuccessful = 1 (treated surgically) | 4 m | Foley’s urethra catheter + circumferential resection + epithelium suture = 1 | Failure of medical treatment = 1 | Successful = 1 | 18 m |