Urethral caruncle as a type of urethral disorder
Urethral caruncle is a medical condition characterized by lesions found in distal urethra. Caruncles may be also described as outgrowths of urethral mucosa that may be up to 1-2 cm in diameter. The lesions usually originate from the posterior urethral lip. They are benign, covered by transitional epithelium, and are more likely to occur in elderly postmenopausal women. Urethral caruncles are rare in childhood and in males.
Causes of this condition are poorly understood. It is considered that low level of female hormone estrogen can cause it, but it is not for sure. Some urologists believe that it is caused by the urethral prolapse. Still, some women may be affected by the disease with no obvious reasons.
Symptoms and consequences
Urethral caruncles’ common symptoms include different urination problems, among which are:
- dysuria, or pain during urination;
- blood in urine;
- blood may be noticed on the underwear or toilet paper;
- women sometimes may discover a lump at the meatus of the urethra;
- dyspareunia, or pain during sexual intercourse, is experienced in some cases.
But caruncles often pass asymptomatic, and therefore the disorder is often revealed without being suspected, just during regular examination.
Urethral caruncles may cause a range of other urethral disorders, like chronic hematuria, urethritis and different infections.
Diagnosis and treatment
Caruncles are rather difficult to diagnose. This condition is often confused with urethral prolapse, as they look similar, or with carcinoma.
In case of caruncles, physical examination shows reddish membrane protruded from the opening. Lesions may appear to be purple or black as a result of thrombosis. Caruncles are usually soft and tender. Some additional tests are performed to confirm the diagnosis, like cystoscopy, biopsy or MSU (mid-stream specimen of urine).
Depending on the severity of the symptoms, different treatments are performed. In order to manage the symptoms hormone estrogen creams and anti-inflammatory drugs are applied and warm sitz baths are taken. In most cases these treatment proves to be efficient. Surgical removal is required as the last resort, when the lesions become too large and the symptoms cannot be managed.
Surgical operation involves excision of the lesions and suture of normal mucosa. Further application of estrogen cream for 1-2 weeks after the surgery may reduce the risk of caruncles recurrence. A catheter is left in urethra sometimes for several days for appropriate healing.
The surgery is performed either using local or general anesthesia, depending on health status of the patient. The operation is performed in a hospital, not in an urologist’s office. The procedure of excision is rather simple and normally doesn’t cause complication, bleeding or infections; it may only be difficult to urinate in first few days after the surgery.
Diathermy is performed sometimes as an alternative to excision.
There is no way to prevent urethral caruncle, as its causes are not understood. Women just should make regular examinations at the urologist to reveal the lesions at the early stages. Although caruncle is not a life-threatening disease, it should be treated as soon as diagnosed to prevent aggravation and complications.
These articles can be used for informational purposes only. To get an accurate diagnosis consult your doctor!