Health Diseases

 


Urethral Caruncle - Causes, Symptoms and Treatment

Urethral caruncle is a most commonly found in postmenopausal females. Urethral caruncles are common in elderly women. Urethral caruncle is a benign lesion of the distal urethra. Urethral caruncles may develop from several simultaneous processes, as discussed in the Pathophysiology section. Urethral prolapse has a similar appearance, but it is more common in preadolescent girls. Urethral caruncles, which often originate from the posterior lip of the urethra, may be described as fleshy outgrowths of distal urethral mucosa. They are usually small but can reach 1-2 cm in diameter.Chronic irritation contributes to the growth, hemorrhage, and necrosis of the lesion. Microscopically, a urethral caruncle looks like a bed of granulation tissue covered by either squamous or transitional epithelium. Infolding of epithelium may create papillary architecture. Inflammatory infiltration is common. Urethral caruncles may be associated with tuberculosis, intestinal ectopia, and unusual neoplasms. Other symptoms include bleeding and urination problems (frequency, urgency and pain). It is usually spotted on an examination with no symptoms present.

Urethral caruncles are not related to urethral cancer or any other type of cancer. The primary sign of this problem is a thin, reddish membrane protruding from one portion of the urethral opening. Many present as bleeding or blood on the undergarments. Some caruncular lesions may look like urethral carcinoma.Urethral caruncles most often occur in girls before puberty and in women after menopause. The exact cause of urethral caruncles isn't clear, but they are thought to be associated with low levels of female hormones. urethral caruncle is usually found incidentally during an examination done for some other reason. If the caruncle is causing irritation or pain, treatment may include is Surgical removal of the caruncle Hormone creams applied directly to the caruncle Soaking in a warm bath Urethral caruncles are rare in childhood.

Causes of Urethral caruncle

Common causes of Urethral caruncle

  • Originate from the posterior lip of the urethra, may be described as fleshy outgrowths of distal urethral mucosa.
  • Perimenopausal women
  • Squamous or transitional epithelium.
  • Some caruncular lesions may look like urethral carcinoma.

Symptoms of Urethral caruncle

Common Symptoms of Urethral caruncle

  • Difficult or painful urination.
  • Blood in the urine.
  • Tenderness or irritation.
  • Soaking in a warm bath.
  • Surgical removal of the caruncle.
  • Painful micturition or dyuspareunia.
  • Bloody spotting with mild trauma.
  • Pedunculated red mass that is tender to touch.

Treatment of Urethral caruncle

Common Treatment of Urethral Caruncle

  • Warm sitz baths.
  • Topical estrogen cream and topical anti-inflammatory drugs.
  • Surgical excision.
  • Cystourethroscopy to rule out bladder and urethral abnormalities. Many urologists perform a cystoscopy in the office, upon initial patient presentation, to rule out other pathologies.
  • Use stay-sutures in the epithelium to prevent mucosal retraction and meatal stenosis.
  • Oversew the edges with 3-0 or 4-0 chromic sutures.

 

 

 

 

 

 

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