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Table 1 Characteristics and clinical presentation of children with urethral prolapse

From: Conservative approach for the treatment of urethral prolapse in children: case report and literature review of 278 pediatric cases

Source Baseline characteristics Clinical findings
Number of patients (gender) Age Ethnicity (skin color) Reason for referral Other symptoms Medical history Prolapse description
Zhang et al. (2020/China) [7] n = 8
All females
[1 month–10 years] NR Vaginal bleeding = 8 NR NR NR
Novoa-Carballal et al. (2018/Spain) [20] n = 1
All females
8 y.o (White) = 1 Vaginal bleeding = 1 Itching NR Painless red, friable circular mass occupying the central part of the vulva introitus
McCaskill et al. (2018/USA) [4] n = 1
All females
6 y.o (White) = 1 Vaginal bleeding = 1 Urinary frequency
Urinary urgency
Dysuria constipation
Abdominal pain
No remarkable history 2 cm in diameter, tender, irregularly shaped, friable, exuberant, and erythematous with dark purple-colored peripheral margins
Wei et al. (2017/China) [3] n = 89
All females
[0.92–12.7] y.o NR Vaginal mass = 54
Vaginal bleeding = 34
Dysuria = 1
NR Malnutrition = 29
Urinary tract infection = 9
Cough = 17
Vulvitis = 5
Diarrhoea = 7
Constipation = 3
A 0.5–3 cm lump protruding from the urethra with clearly visible central urethral opening
Liu et al. (2017/China) [6] n = 7
All females
[2–8] y.o NR Vaginal bleeding + mass = 7 Hematuria = 1
Urodynia = 1
Respiratory infection = 4
History of trauma = 1
A mass protruding out of the vaginal opening
Lora et al. (2017/Italy) [14] n = 1
All females
8 y.o Caucasian (white) = 1 Vaginal bleeding = 1 NR Constipation = 1 Red ‘doughnut’-shaped lesion surrounding the urethral meatus
Kondamudi et al. (2014/USA) [19] n = 1
All females
6 y.o African American (black) = 1 Vaginal bleeding = 1 NR No remarkable history A round doughnut-shaped reddish-colored mass protruding from the urethral opening
Ballouhey et al. (2014/France) [1] n = 28
All females
[3–9] y.o (Black) = 17
NR = 11
Vaginal bleeding = 17
Urinary symptoms = 2
Vaginal pain = 6
Not reported = 3
NR Chronic constipation = 2
Chronic cough = 2
Cerebral palsy = 1
Urinary tract infections = 3
Upper respiratory illness = 3
An inflamed and friable mass that closed the vaginal opening was observed; the urethral orifice was found in its center
Ballouhey et al. (2013/France) [15] n = 1
All females
5 y.o NR Vaginal bleeding = 1 NR No remarkable history 2 cm urethral protrusion with ulceration and blood clots
Holbrook et al. (2011/UK) [8] n = 21
All females
[2–15] y.o (Black) = 21 Urethral mass = 8
Vaginal bleeding = 6
Dysuria = 6
Leucchorea = 1
Constipation = 1
NR NR All had 0.5–2 cm urethral lump with clearly visible central opening = 21 Blue coloration = 3
Aprile et al. (2011/Italy) [2] n = 1
All females
6 y.o Caucasian (white) = 1 Vaginal bleeding = 1
Sexual abuse = 1
NR Trauma (fall) = 1 Red mucous membrane prolapsed form the urethra
Fiogbe et al. (2011/Benin) [12] n = 9
All females
[2.5—10] y.o NR Vaginal bleeding = 5
Vaginal mass = 2
Dysuria = 2
NR No remarkable history 0.75 to 1 cm ring-shaped congested, oedematous, non-tender mass
Vunda et al. (2011/Switzerland) [16] n = 1
All females
2.5 y.o (Black) = 1 Vaginal bleeding = 1
Sexual abuse = 1
NR No remarkable history 0.5-cm circumferential prolapsed mass
Pereira et al. (2011/UK) [17] n = 1
All females
5 y.o (Black) = 1 Vaginal bleeding = 1 NR No remarkable history Congested, friable, purplish red doughnut-shaped mucosal mass
Ekenze et al. (2009/Nigeria) [10] n = 3
All females
[3–5] y.o NR NR NR NR NR
Hillyer et al. (2009/USA) [5] n = 34
All females
[5 months–12 years] (Black) = 34 Vaginal bleeding = 34 Dysuria = 10 Trauma (fall) = 3
Sexual abuse, STDs = 1
Trauma (pelvic) = 1
Preterm delivery = 4
Asthma = 7
Upper respiratory illness = 5
Hernia = 2
Pneumonia = 1
Mitral regurgitation = 1
stomach cramps = 1
Protruding, congested, and edematous bleeding, fleshy mass surrounding the external urethral meatus
Agarwal et al. (2008/UK) [9] n = 2
All females
(4, 4.5) y.o Afro-Caribbean (black) = 2 Vaginal bleeding = 2 NR No remarkable history Typical ‘‘doughnut’’ appearance of urethral prolapse
Shurtleff et al. (2002/USA) [13] n = 3
All females
[3, 6, 8] y.o NR Vaginal bleeding = 3
Sexual abuse = 1
Moderate pain = 3
Dysuria = 1
No remarkable history Ring of congested, edematous tissue prolapsing through the urethral meatus
Silva-Anoma et al. (2001/Ivory Cost) [11] n = 65
All females
[6 weeks–14 years] African (Black) = 65 Vaginal bleeding = 29
Hematuria = 5
Urethral mass = 1
Sexual abuse = 5
Vaginal mass = 4
Urethral Prolapsus = 7
Genital malformation = 2
Labia minora hypertrophy = 2
Leucchorea = 4
Trauma = 2
Not precise = 4
Asymptomatic = 13 NR Circular eversion under the clitoris
McKenna et al. (1999/Queensland) [18] n = 1
All females
7 y.o Caucasian (white) = 1 Vaginal bleeding = 1 NR Mild asthma = 1 1.5 cm fleshy, mulberry like lesion with intact hymen = 1
  1. Abbreviation: y.o, years old; NR, not reported; TEC, topical estrogen cream; ATB, antibiotics; STDs, sexually transmitted diseases; Cath, catheterization