PANCE Blueprint Genitourinary (5%)

Urethral disorders (PEARLS)

Urethral Prolapse Circumferential protrusion of the distal urethra through the external urethral meatus. It is a rarely diagnosed condition that occurs most commonly in prepubertal girls and postmenopausal women

  • Vaginal bleeding is the most common presenting symptom of urethral prolapse
  • Upon examination, round, often doughnut-shaped protrusion mucosa is observed obscuring the urethral opening

Treatment includes topical estrogen creams, vaseline, and sitz baths

  • Surgical excision is justified in young patients with symptomatic urethral prolapse or with recurrent urethral prolapse
Urethral Stricture Narrowing of the urethra caused by injury, instrumentation (TURP), infection (typically with Gonorrhea) and certain non-infectious forms of urethritis

  • A urethral stricture should be suspected in men with chronic obstructive voiding symptoms, especially if noninvasive studies (eg, uroflowmetry, ultrasound postvoid residual measurement) demonstrate poor bladder emptying with a low peak rate of urine flow

Treatments include urethral dilation or stent placement

  • An open urethroplasty is an option for longer, more severe strictures
Testicular torsion (Lecture) (Prev Lesson)
(Next Lesson) Urethral Prolapse
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