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Urethral Prolapse, the condition that could get a man in jail for nonexistent rape of a minor

Rape and defilement are the only things people wil think about when they find a 5-year-old bleeding from the private with a male adult

HEALTH—The mother was angry. On various news channels, her face was contorted with pain as she accused a teacher at a school–where her daughter studied from–of rape. The poor child is only four years old.

The world is full of bastards, so kids aged four or even younger have been raped by some human-animals before so this mother’s accusations were not entirely new. Not least, far-fetched. Her daughter was found bleeding from her private parts, which also appeared to have injuries. She had taken the poor girl to hospital for a medical checkup…

When a pre-pubertal girl bleeds from the private parts and appears to have injuries around the pelvis, rape is the only conclusion that comes to mind. Woe unto a man who will have been in contact with the child. In fact, there are many who have been lynched after being found with bleeding kids, a few ‘lucky’ ones have ended up in jail, often paying for nonexistent crime to begin with.

Having watched the news on local TVs, Joshua Kato, a veteran New Vision journalist, posted about a similar experience with his daughter. The kid had returned home with a lot of blood flowing from her private parts, he said.

“We rushed her back to her school, suspecting a case of defilement. The school nurse indeed confirmed that the kid was raped! We rushed to the next clinic where it was also confirmed defilement,” Kato posted on his Facebook wall.

Not to downplay the Mityana case that was in the news last week but Kato appears to have his point.

“If I was the type to loose ‘wires’ so fast, I would have ‘arrested’ the nearest person around. Something within me still had doubts. The girl was playing around so lively that beyond the blood, there were no other signs of defilement. But rather than make a conclusion, we sought the services of another doctor, Dr Mwanje [Haruna, obstetric gynaecologist at National Referral Hospital Mulago] from Mulago hospital.”

TREATMENT
Vaseline: The Vaseline will act as a barrier to help alleviate any sensitivity associated with the prolapsed urethra.
Sitz baths: A warm, shallow sitz bath twice a day for 15 to 20 minutes will help the urethral prolapse area heal and keep the area clean.
Surgery: Sometimes, medical treatment does not resolve the urethral prolapse. If your child continues to have symptoms, surgery may be needed.

Mwanje examined the little girl afresh and drew the conclusion that there was no sign of rape or defilement, but rather a condition called urethral prolapsed.

“In fact, he added, ‘There are many innocent men who were left in the care of young girls, who are in prison for defilement because of such misinterpreted cases,’” Kato said.

Dr Sabrina Kitaka, a paediatrician at Mulago hospital, said that before a child is declared as having been defiled, it is important to do a good history and thorough physical examination under calm and confidential circumstances.

Dr Andrew Chakura, obstetric gynecologist at the City Hospital, said a child reporting history suggestive of defilement may present with per vaginal bleeding, which is sometimes the presentation for urethral prolapse.
“If keen attention is not taken during medical assessment, then a genital prolapse can be missed,” he warned.

What is urethral prolapse?

The urethra is the tube that drains urine from the bladder to the outside of the body. Urethral prolapse occurs when the inner lining of the urethra sticks out. When this happens, the opening of the urethra looks like a small pink donut and seems larger than normal.

Dr Kitaka shared with this news website the 2015 case reports published by the Journal of Pediatric Surgery. The report covered urethral prolapsed, a rare urological condition with non-specific clinical manifestations which is mostly seen in pre-pubertal black girls and postmenopausal woman.

Scientists are still not sure of the cause of urethral prolapsed, but Kato said that Dr Mwanje had told them that the condition occurs in young girls, especially those who fight the urge to go to the toilet.

“My daughter hated going to the school toilets and instead keeps the urine until she came back home. Because of the pressure, blood collects and creates a swelling around the urethra, before it bursts, letting off a lot of blood. To the lay eye, it looks like the child has been defiled. People further mistake the wound created after the swelling bursts as a result of the defilement,” Kato said.

Other medical journals cite that urethral prolapsed is more likely to happen to girls who have a history of heavy coughing, constipation, urinary tract infections, trauma or who are obese. All of these conditions can increase pressure inside the belly, which may lead to urethral prolapse.

Challenge in investigations

It is essential to recognise urethral prolapse but under many circumstances, guardians of the child would be too angry to rationalize, which jeopardizes investigations even further. Most parents would be unwilling to believe any other explanation other than a confirmation that their child had been raped and the culprit had to pay.

Yet having an accurate diagnosis is a must in cases of defilement and rape lest a wrong judgement be given by courts on conclusions and evidence drawn in a medical report. minimizing unnecessary investigations.

When such cases go to court, it is evidence and reports from medical examinations that form the basis for prosecution.

“Determination of defilement is mainly by courts of law. Medics only take history ,perform physical examination and collect forensic evidence for cases of suspected defilement. Then it is up to courts of law to corroborate the evidence,” Dr Chakura said.

Although the medical condition is bad news for men around children, when it happens, there are some ways to manage. But a parent lives to see their daughter free of such heartrending scenarios so it is best to watch out for some of the potential causes such as holding urine and other conditions that cause too much pressure on the bladder.

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