Ahealthy 2-1/2 year-old girl presented to the emergency department with genital bleeding, which began that morning. Her history revealed no trauma, no fever, and no dysuria. The parents were concerned that their child may have been sexually abused. The mother was of African origin, and the father was Caucasian. On physical examination, a 0.5-cm circumferential prolapse of the urethra was revealed (Figure). Bleeding of the protruding burgeon was triggered on application of sterile compresses. Results of a laboratory work-up were normal for both cellular blood count and routine coagulation tests. The child was discharged with treatment by promestriene, a topical estrogen cream, two times daily and sitz baths with camomile. On day 5, bleeding had stopped, and the urethral bourgeon had not progressed. The treatment was continued for 14 days, and the child was seen at week 6 with complete regression of the urethral bourgeon. To date, at 20 months of follow-up, there has been no relapse; however, this girl is being treated for theliarchy possibly related to estrogen treatment.
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