Transperineal sonographic findings in a woman with urethral mucosa prolapse

We present a case of urethral mucosa prolapse in a postmenopausal woman. Transperineal gray-scale sonograms revealed a clover-shaped, hypoechoic mass protruding from the urethral meatus. Doppler studies revealed blood flow within the protruding mass. Detection of feeding arteries and draining veins contributed to exclude the possibility of necrosis and gangrene, thus allowing conservative medical treatment to be tried. The mucosal prolapse regressed after 1 week's treatment with topical estrogen and antibiotics and sitz baths. Follow-up sonograms showed a normal urethral configuration and diminished vascular flow when compared with the initial study.