Successful non-surgical management of genital prolapse in a neonate with thoracolumbar meningomyelocele using a bottle nipple device: Case report.

Genital prolapse is very rare in neonates. In neonates affected by spina bifida, genital prolapse can occur due to improper nerve supply to the pelvic diaphragm. When genital prolapse occurs in neonates, it can be associated with severe morbidity as time goes on, since inflammation and infection can develop. This study reports a 3-day-old female neonate who presented with genital prolapse associated with meningomyelocele, which was successfully treated with bottle nipple support left for 5 days after digital reduction and surgical repair of the meningomyelocele. Type one genital prolapse in neonates can be successfully treated with surgical meningomyelocele repair, digital reduction of the prolapse, and leaving a bottle nipple in the vaginal canal. However, given that the meningomyelocele repair was performed shortly before reduction and that spontaneous resolution after spinal repair has been reported, the success of bottle nipple device use can be associative rather than causal. After leaving a bottle nipple in the vaginal canal, the following precautions should be taken to decrease the risk of vaginitis. A new bottle nipple, which has never been previously used for feeding, should be used, and the bottle nipple insertion should be done using sterile gloves. The perineal area should be cleaned with sterile saline during routine diaper changes. Last but not least, the genital area should be closely inspected for any change of color, swelling, discharge, or expulsion of the bottle nipple.