The urethra, like any other part of the body is made up of different layers. The mucosa is the innermost layer and is therefore comes in direct contact with the urine.
A mucosal prolapse is when the distal portion (portion near the end of the urethra) of mucosa turns out through the urethral meatus (opening or end of the urethra). It typically looks like a pink to purple mass and can easily be confused with a tumor.
The area is often tender to touch and is friable (bleeds easily with only minor irritation). A urethral prolapse may revert spontaneously with warm baths and observation. Those that are very severe fail to revert on their own or are recurrent and require a surgical procedure. Excision is a short procedure and is performed on an ambulatory basis.
Preparation of the Procedure
In any procedure in which the anesthesia is used, the doctor will be asked not to feed the patient anything (including any liquids) after midnight, the evening prior to the surgery.
If the patient is on medications that must be taken, he will have discussed this with the doctor or the anesthesiologist and instructions will have been given to the patient.
If safely avoidable, the procedure should not be performed if the patient is on, or has recently been taking any medication that may interfere with his ability to clot his blood. This is rarely of any concern since the procedure is so minor.
The most common of these medications are aspirin-like compounds and all related pain relievers, fever reducers or anti-inflammatory compounds (whether prescription or over-the-counter).
Please refer to the attached list and tell the doctor if the patient took any of these within the past ten days. If his medication is not on the list, alert the doctors immediately so that they may ensure optimal procedure safety.
The doctors will have reviewed any of the current medications with the patient during the pre-operative/pre-procedure consultation. The patient is obligated to inform the doctor if anything has changed (medication or otherwise) since the patient's previous visit.
To review the basics of what the doctors discussed in the office: The procedure usually takes less than one hour. The patient will be placed under general anesthesia so that the patient feels nothing and has no awareness of the surgery.
The excess mucosal tissue is removed so that the remaining mucosal layer is even with the outer layers of the urethra. The edges of the mucosa are then sewn together to the outer layers of the urethra. The sutures stop any bleeding on the edges, and more importantly helps the mucosa to stay in place while it is healing.
The patient will be in the recovery room for a short time before being sent home. The patient may have some discomfort, but usually not any severe pain.
The patient may see a small drop of blood drip from the area. Try to keep the surgical area dry for 24 hours. The doctors ask that the patient refrain from any strenuous activity or rough play for a few days.
Some patients have almost no discomfort while others are somewhat uncomfortable for one to two days longer is rare. The patient may cry the first few times that she urinates. The patient may have a stinging or burning sensation from the urine hitting the recently cut tissue edge.
For discomfort, she may have any pediatric-dose over-the-counter medicine to which she is not allergic. Some surgeons may instruct the patient to put her in the warm bath a couple of times per day. Warm baths may also help the patient urinate if she is holding back.
The sutures doctors use are self-dissolving, and do not require removal. The patient may be asked to apply an antibiotic ointment (i.e. Bacitracin) to the area to prevent the sutures or skin from sticking to undergarments.