DOI: 10.36347/sasjs.2022.v08i07.001

Pages: 467-471

Vulvar or genital hemorrhage is an alarming reason for consultation that worries parents a lot. Several etiologies of vulvar bleeding have been reported, including sexual abuse (common in our socioeconomic context) or urethral prolapse. Urethral prolapse is the complete eversion of the distal congestive urethral mucosa through the urinary sphincter. It is a benign condition that is uncommon in children and occurs in girls with a peak in frequency between the ages of four and six, mainly in the black population. The clinical presentation is dominated by vulvar bleeding, which therefore poses a medico-legal issue and a differential diagnosis with other causes of genital hemorrhage. The diagnosis is purely clinical, presenting as a more or less voluminous pink or purplish edematous circumferential pseudotumor bulge that bleeds spontaneously. No paraclinical examination is necessary. We retrospectively analyzed the records of 12 prepubertal patients aged between 5 and 12 years who consulted for genital hemorrhage either post-traumatic or spontaneous with urethral prolapse in the Pediatric Surgical Emergency urethral prolapse department, over a period of 18 years (1998 - 2020). In our series, the age of diagnosis ranged from 5 to 12 years with a median age of 08 years. Eleven patients were Caucasian and only one patient was from Senegal. Other causes of vaginal hemorrhage were ruled out, including sexual abuse or post-traumatic bleeding. The treatment of this affection is subject to great controversy, between surgical and conservative treatment, all our patients benefited from surgical treatment except one patient who benefited from medical treatment. The risk of complications, in particular urethral stenosis and recurrence, is not negligible in the face of poorly conducted medical treatment or surgery. In our series, the clinical outcome was favorable in all patients. The duration of hospitalization could be shortened by an early removal of the urinary catheter, .......