eMedicine Specialties > Urology > Common Problems of the Urethra
Urethral Caruncle: Workup
Updated: Oct 30, 2009
Workup
Laboratory Studies
- Obtain a urinalysis to rule out urinary tract infection when pain, discomfort, or dysuria is present or when an operative intervention is planned.
Diagnostic Procedures
- Cystoscopy can be performed, either in the office or at the time of excision, to rule out more serious pathologies, but is not necessary when the diagnosis is obvious and no intervention is planned.
Histologic Findings
Microscopically, a urethral caruncle resembles a bed of granulation tissue covered by either squamous or transitional epithelium. Infolding of epithelium may create papillary architecture. Inflammatory infiltration is common (see Image 1).
This image shows marked vascular engorgement and a polymorphous inflammatory infiltrate in the stroma. Surface epithelium is benign. Courtesy of G.T. MacLennan, MD.
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References
Karthikeyan K, Kaviarasan PK, Thappa DM. Urethral caruncle in a male: a case report. J Eur Acad Dermatol Venereol. Jan 2002;16(1):72-3. [Medline].
Nakamoto T, Inoue Y, Ueki T, Niimi N, Iwasaki Y. Primary amelanotic malignant melanoma of the female urethra. Int J Urol. Feb 2007;14(2):153-5. [Medline].
Indudhara R, Vaidyanathan S, Radotra BD. Urethral tuberculosis. Urol Int. 1992;48(4):436-8. [Medline].
Singh I, Hemal AK. Primary urethral tuberculosis masquerading as a urethral caruncle: a diagnostic curiosity!. Int Urol Nephrol. 2002;34(1):101-3. [Medline].
Khatib RA, Khalil AM, Tawil AN, Shamseddine AI, Kaspar HG, Suidan FJ. Non-Hodgkin's lymphoma presenting as a urethral caruncle. Gynecol Oncol. Sep 1993;50(3):389-93. [Medline].
Young RH, Oliva E, Garcia JA, Bhan AK, Clement PB. Urethral caruncle with atypical stromal cells simulating lymphoma or sarcoma--a distinctive pseudoneoplastic lesion of females. A report of six cases. Am J Surg Pathol. Oct 1996;20(10):1190-5. [Medline].
Park DS, Cho TW. Simple solution for urethral caruncle. J Urol. Nov 2004;172(5 Pt 1):1884-5. [Medline].
Martin FM, Rowland RG. Urologic malignancies in pregnancy. Urol Clin North Am. Feb 2007;34(1):53-9. [Medline].
Petersen RO, Stein BS. Genitourinary Pathology. In: Practice of Urology. New York, NY: Norton Medical Books; 1993:48.
Rovner ES. Bladder and urethral diverticula. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology. Vol 3. 9th ed. Philadelphia, PA: WB Saunders Co; 2007:2361-72.
Further Reading
Keywords
urethral caruncle, urethral lesions, caruncula, carunculae, urethral diverticulum, urethral carcinoma, periurethral gland abscess, dysuria, distal urethral prolapse, estrogen deficiency, epithelium, polymorphous inflammatory infiltrate


Workup: Urethral Caruncle