Spontaneous irreducible urethral prolapse in a post-menopausal woman: a rare differential diagnosis of an intralabial mass

Excerpt

A 58-year-old, post-menopausal woman presented with a gradually progressive mass near the urethral opening with associated pain for 6 months and two episodes of mild, gross, painless, intermittent hematuria. She had no urgency or incontinence. Examination revealed a donut-shaped mass surrounding the urethra. The urethra and bladder were normal on cystoscopic examination, which was performed in view of the history of gross hematuria. Uroflowmetry showed a normal micturition pattern. A clinical diagnosis of urethral mucosal prolapse was made (Fig. 1). An attempt to reduce the mass after liberal application of lignocaine jelly was unsuccessful (Fig. 2). Conservative management with local application of estrogen cream did not result in reduction of the mass. The urethral catheter was removed after 10 days and she voided comfortably with no stress leakage. Histopathological examination revealed squamous metaplasia and chronic inflammation.

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