What is a urethrocele (urethral prolapse)?

Kevin W. Windom, MD
OBGYN (Obstetrics & Gynecology)
The urethra is the tube that comes out of the bladder and allows you to urinate. The word “cele” means a hernia (tear in the supportive connective tissue). So an urethrocele is a hernia of the urethra. The symptoms in a woman can be painful urination, a bulge in the anterior vaginal wall, urinary incontinence, or recurrent urinary tract infections. If there are no symptoms, then there's no reason to treat this problem. If a patient needs to have her urethrocele (also known as a urethral prolapse) surgically treated, then it is usually outpatient surgery where the hernia is excised, the connective tissue is repaired and a catheter is inserted into your bladder for 3-5 days to allow for healing.
A urethrocele occurs in women when the urethra (the tube from the urinary bladder to the outside) prolapses or descends downward into the vagina. This can result from stretching or weakness of the supporting muscles. The muscles can weaken with age or the defect can be present at birth (congenital).

A urethrocele can develop if the supporting muscles become damaged from prolonged labor, childbirth and/or prior pelvic surgery.

Symptoms can range from incontinence (leakage of urine) to urinary retention or inability to fully empty the bladder, which may lead to bladder infections.

If there are no symptoms, then treatment may not be necessary. Treatment may include certain exercises to strengthen the pelvic muscles, or surgical correction in some cases.
The urethra is a tube which carries urine from the bladder. In women, a urethrocele is a protrusion of the urethra in to the vagina. There are various degrees of this prolapse, from very slight and mild to bulging and completely visible in the vagina.

Risk factors for developing a urethrocele include pregnancy, advanced age, menopause and obesity.

The urethrocele is often associated with urinary incontinence (leaking). X-rays (for example, voiding cystourethrogram VCUG, intravenous pyelogram IVP) and urodynamic testing (filling & emptying bladder and measuring amounts and pressures) are often used in the diagnosis.

Treatment may begin with exercise and weight loss to reduce abdominal pressure. Biofeedback and specific exercises (such as Kegels or weighted cones) can be used to strengthen the surrounding muscles. Medicines may also be necessary. A pessary (stiff ring) can be fitted to reposition the urethra to lessen leakage, although if this does not work, it may require a surgical procedure to reduce the prolapse and correct the leakage. Urologists or urogynecologists are the medical specialists in this area and should be considered for consultation and/or treatment.

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