• Noah P Kondamudi, Ayush Gupta, Amina Watkins, and Amy Bertolotti.
• Division of Pediatric Emergency Medicine, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey.
• J Emerg Med. 2014 Jun 1;46(6):769-71.

BackgroundPrepubertal children with vaginal bleeding are frequently brought in to the Emergency Department (ED) for evaluation with the primary concern of sexual abuse. Appropriate history and physical examination can help recognize the specific cause and allay anxiety of parents and reduce unnecessary work-up.ObjectiveThe purpose of this report is to describe a frequently unrecognized cause of vaginal bleeding that is unrelated to sexual abuse.Case ReportWe report the case of a 6-year-old African-American girl referred to our ED as a case of vaginal bleeding with suspicion of sexual abuse. She was clinically diagnosed to have urethral prolapse.ConclusionIn prepubertal girls with vaginal bleeding, urethral prolapse should be strongly considered as a diagnostic possibility. Increased physician awareness and early recognition of urethral prolapse avoids unnecessary examinations and patient anxiety and prevents misdiagnosis as sexual abuse.Copyright © 2014 Elsevier Inc. All rights reserved.

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