Urethral Prolapse: Symptoms, Causes, Treatment

What are the symptoms of urethral prolapse?

Urethral prolapse occurs when the urethra protrudes through the vaginal opening or external genitalia. The symptoms can vary in severity and may include:

• Visible Protrusion: A noticeable bulge or protrusion of the urethra from the vaginal opening or external genitalia.
• Pain or Discomfort: Pain or discomfort in the pelvic area, which may be more pronounced during urination or sexual activity.
• Frequent Urination: Increased frequency of urination or a constant urge to urinate.
• Difficulty Urinating: Difficulty initiating urination or a feeling of incomplete bladder emptying.
• Bleeding: Light bleeding or spotting from the vaginal or urethral area.
• Urinary Incontinence: Unintentional leakage of urine, especially during physical activity or coughing.
• Urinary Tract Infections: Increased susceptibility to urinary tract infections (UTIs), which may present with additional symptoms like burning during urination or cloudy urine.

If you suspect urethral prolapse, it’s important to consult a healthcare provider for an accurate diagnosis and appropriate treatment.

What are the causes of urethral prolapse?

Urethral prolapse can result from several factors, often related to pressure changes or weaknesses in the pelvic support structures. Common causes include:

• Weak Pelvic Support: Weakness or loss of support in the pelvic tissues, often due to aging or childbirth, can lead to urethral prolapse.
• Increased Abdominal Pressure: Conditions or activities that increase abdominal pressure, such as chronic coughing, constipation, or heavy lifting, can contribute to prolapse.
• Hormonal Changes: Hormonal changes, especially those related to menopause, can affect the elasticity and strength of the pelvic tissues.
• Genetic Factors: Some individuals may have a genetic predisposition to weaker connective tissues or structural abnormalities that increase the risk of prolapse.
• Childbirth Trauma: Vaginal delivery, especially of large babies or multiple births, can weaken the pelvic support structures and contribute to urethral prolapse.
• Pelvic Tumors or Masses: Tumors or masses in the pelvic area can exert pressure on the urethra and contribute to prolapse.
• Previous Surgery: Previous pelvic surgeries or trauma can affect the pelvic support structures and increase the risk of prolapse.

Addressing underlying causes, managing contributing conditions, and seeking medical advice can help in preventing and treating urethral prolapse.

What is the treatment for urethral prolapse?

The treatment for urethral prolapse depends on the severity of the condition and the symptoms experienced. Options typically include:

• Conservative Management: For mild cases, conservative approaches may be sufficient. This can include pelvic floor exercises to strengthen the surrounding muscles and manage symptoms.
• Topical Estrogen Therapy: In postmenopausal women, topical estrogen creams can help improve the elasticity and strength of the vaginal and urethral tissues, which may help alleviate symptoms.
• Surgical Intervention: For more severe cases, surgery may be required to repair the prolapse. Surgical options can include:
• Urethral Sling Procedures: These involve placing a mesh or sling to support the urethra and prevent it from prolapsing.
• Urethral Reconstruction: This surgical technique aims to restore the normal position and function of the urethra.
• Vaginal Repair Surgery: If the prolapse is associated with vaginal wall weakness, a combined approach may be used to repair both the vaginal wall and the urethra.
• Management of Contributing Factors: Addressing any underlying conditions contributing to the prolapse, such as chronic cough or constipation, can be an important part of treatment.
• Lifestyle Modifications: Implementing lifestyle changes like weight management and avoiding activities that increase abdominal pressure can help manage symptoms and prevent recurrence.

Consulting with a healthcare provider is crucial to determine the most appropriate treatment based on individual needs and the severity of the prolapse.