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What Is Urethral Prolapse?

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It's not quite the same as pelvic prolapse. Pelvic prolapse is the abnormal descent of female pelvic organs into the vagina, or out the vaginal opening.

This would include cystocele for the bladder, rectocele for the rectum, enterocele for the small intestine, vault prolapse for the vaginal apex after hysterctomy, or procidentia for uterine descent. It is an abnormal herniation of these organs due to intra-abdominal pressure pushing down on these organs as a result of poor pelvic floor support.

A urethral prolapse, also known as a urethral caruncle, is the mucosal lining of the urethra that protrudes and is visible at the urethral opening. It is not caused by pelvic floor weakness, rather, in women, it is caused by menopause and the low estrogen staus of the vagina and urethra. The prolpase will appear like a small red pimple on the urethral meatus (opening). It is usually of no significance, but its presence indicates hypo-estrogenization.

Uncommonly, it can bleed or cause blood spotting in the urine or cause pain if it gets large. If large, it can cause deflection of the urinary stream. If it doesn't bother the woman, then nothing has to be done. If the vagina is dry already, consideration can be given to applying local estrogen cream to help the prolapse retract and improve the vaginal health. If the urethral prolapse is spotting blood or painful, estrogen cream should be applied. Only when estrogen cream has not worked or if large and painful does the prolapse need to be removed in the operating room.

A urethral prolapse is NOT a polyp of the urethra. Most polyps of the urethra are benign and can be removed surgically. Tumors of the female urethra are rare entities, but present as polyps and are removed as well.


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EmpowHER Guest

I was diagnosed with urethral prolapse/urethral caruncle two months ago. I have been using Estrace Cream & physical therapy pelvic floor exercises. Two days ago, the caruncle was surgically removed as it was quite large. Today, it feels as though it's prolapsed. Is that possible? Thanks.

December 31, 2017 - 10:35am
EmpowHER Guest

Thank you for providing this information. I am currently being treated for an extremely large urethral prolapse with Estrace 2X day. The urologist had two other doctors, two physician assistants and a nurse examine me, and said he wished they had taken photos at the beginning of the treatment. At the end of a month of treatment the size has decreased by 1/3 and the urologist was very pleased , but said it is still large compared to the norm and to continue treatment. I was very relieved to be able to see more about it here, and have what he told me reinforced.

March 26, 2010 - 8:41pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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