A premenarcheal girl with urogenital bleeding

An 8-year-old Caucasian girl was referred with perineal bleeding of sudden onset during micturition. There was no history of trauma, fever or dysuria, but she had a history of constipation. Family history was unremarkable. Physical examination showed a prepubertal girl with a red ‘doughnut’-shaped lesion surrounding the urethral meatus (figure 1). Laboratory findings, including platelet count and coagulation, were normal. A vaginoscopy, performed using sedation, was negative. Swabs tested negative for sexually transmitted pathogens. A diagnosis of urethral prolapse (UP) was made on clinical appearance. Treatment with topical oestrogen cream was started and constipation treated with oral polyethylene glycol. On day 10, the bleeding stopped, and at week 5 there was a moderate regression of the UP. However, occasional mild bleeding persisted at 10 months, so she was referred to a urologist (figure 2). UP is an eversion of the distal urethral mucosa through the external...

Source: Archives of Disease in Childhood - April 19, 2017 Category: Pediatrics Authors: Lora, A., Scrimin, F., Taddio, A., Ventura, A., Barbi, E. Tags: Constipation, Urology, Journalology, Pain (neurology), Reproductive medicine, Child abuse, Child health, Sexual health, Competing interests (ethics), Drugs: endocrine system Images in paediatrics Source Type: research