Urethral Prolapse in an Elderly Postmenopausal Woman: A Case Report

Urethral prolapse, as the name suggests, is an outward protrusion of the urethral mucosa of the distal part through the meatus. It is rarely seen in practice but when encountered, tends to occur in pre-pubescent and post-menopausal females. Presentations vary from having no symptoms to complications like strangulation, urinary retention etc. We report an 85-year-old postmenopausal woman who presented initially to the Gynaecology out-patient department under the impression of vaginal bleeding. After excluding gynaecological issues, urology consultation was sought. On query, she mentioned lower urinary tract symptoms (predominantly storage) for 1 year and blood staining in undergarments for the last 4 days. Examination revealed a red, fleshy, globular urethral mass approximately 2 cm in diameter. A per-urethral Foley catheter was inserted without difficulty through the central opening, with efflux of clear urine, confirming urethral prolapse. Surgical excision was performed under spinal anaesthesia. Urethrocystoscopy prior to the excision showed unremarkable findings. The mucosa was circumferentially excised and secured to the margins of the urethral meatus using glyconate 4-0 suture. The catheter was removed on the 14th postoperative day, and histopathological examination confirmed normal urethral mucosa without dysplasia or malignancy. All presenting symptoms resolved completely, and the patient remained asymptomatic at 12 months of follow-up. Urethral prolapse, although rare, should be kept in the differentials of a vulvar mass with urinary symptoms in elderly postmenopausal women. Since the diagnosis is mainly clinical, meticulous examination is essential to prevent misdiagnosis and mistreatment. Medicine Today 2026, Vol.38 (2): 329-331