Is it common?
A urethral caruncle is a small, benign vascular growth that usually occurs at the back part of the distalmost end of the urethra. Your urethra is the duct through which urine exits your body.
They are mostly found in women who have been through the menopause. A urethral caruncle is the most common benign tumor that occurs in the urethra in postmenopausal women. Females who are premenopausal can also develop a urethral caruncle, but this is rare.
It’s even rarer for men to develop a urethral caruncle. There’s only ever been one reported case in the medical literature.
Unless it’s causing uncomfortable symptoms, this type of growth usually isn’t cause for concern. Keep reading to learn more about the symptoms, diagnosis, treatment, and more.
What are the symptoms?
Urethral caruncles are usually pink or red. If a blood clot has formed, they may turn purple or black.
These growths are usually small, growing up to 1 centimeter (cm) in diameter. However, cases have been reported where they’ve have grown at least 2 cm in diameter.
They typically sit on one side of the urethra (the posterior edge), and don’t go around the whole circle of the opening.
A urethral caruncle typically won’t cause any symptoms. Most people don’t even know it’s there until their doctor points it out during a routine examination.
However, pain and bleeding are possible. For example, some women report a burning pain when they urinate.
What causes this condition and who’s at risk?
A low estrogen level in a female is associated with a higher risk for having a urethral caruncle.
Estrogen naturally keeps your genital area skin flexible and lush. If your levels drop, your skin may dry, thin down, tear easily, and become prone to other irritation.
This may be why urethral caruncles are most common in women who have gone through menopause. During this time, your estrogen level drops to a lower amount, and menstruation stops completely.
There have also been a few cases where a urethral lesion looked similar to, but wasn’t, a urethral caruncle. These include cases of the urethra affected with the following:
How is this condition diagnosed?
A urethral caruncle is usually discovered during a routine pelvic examination. However, it can be tricky to visually determine whether the growth is truly a urethral caruncle or another type of lesion, such as a carcinoma (a type of cancer tumor).
If your doctor is uncertain, they may take a tissue sample (biopsy) to determine whether the growth is cancerous. They may also perform a cystourethroscopy to look for abnormalities inside your urethra and urinary bladder.
Your doctor will advise you on next steps once they make a diagnosis.
What treatment options are available?
Treatment isn’t necessary unless the growth is causing symptoms. If you’re experiencing pain or other discomfort, your doctor will develop a treatment plan to reduce inflammation and correct the root cause.
A typical treatment plan may include topical estrogen cream to help restore your levels and a topical anti-inflammatory medication to further ease symptoms.
Your doctor may recommend surgical removal if the growth is abnormally large and causing significant symptoms, isn’t responding to less intensive treatment, or the diagnosis is otherwise unclear.
This procedure typically involves cystourethroscopy, excision, and biopsy and usually has excellent success rates. Some people may have just local anesthesia, others may receive sedation or deeper anesthesia. The procedure typically takes up to an hour to complete and around two weeks to recover from.
Are complications possible?
Urethral caruncles often resemble more serious conditions, such as urethral cancer. If the growth is diagnosed as a urethral caruncle when it’s actually something more severe, complications could arise from delaying treatment.
What’s the outlook?
These lesions usually don’t cause symptoms. If you find that you’re experiencing pain or bleeding, make an appointment to see your doctor. They can prescribe medication to ease or even eliminate your symptoms.
If you’re symptoms worsen after treatment, surgical removal may be necessary.