Urethral Mucosal Prolapse

Urethral mucosal prolapse occurs when the lining of the urethra protrudes outside the opening of the urethra (urethral meatus). This can occur in young girls, postpartum women (especially if breastfeeding), and postmenopausal women. Urethral prolapse is caused by low levels of estrogen. The tissue loses elasticity and slides down and out of the inside of the urethra. Some people use the word “prolapse” and “caruncle” interchangeably. The only difference between the two is that urethral prolapse is completely prolapsed on all edges and a caruncle is just prolapse on the lower edge of the urethral opening.

Many women with this condition do not have any symptoms. However, sometimes women experience spotting or pain if the prolapse is extreme.

Treatment is not necessary unless the symptoms are bothersome. Topical estrogen cream is the usual first line of therapy. If topical estrogen does not improve symptoms or the patient does not want to use estrogen, CO2 laser treatments with Mona Lisa Touch are highly effective. For this condition, laser therapy is covered by insurance and is not painful. In extreme cases, surgical excision of the prolapsed tissue is sometimes needed.