Urethral Caruncle Workup

  • Author: Kamran P Sajadi, MD; Chief Editor: Edward David Kim, MD, FACS   more...
 
Updated: Aug 15, 2011
 

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.

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Diagnostic Procedures

A urethral caruncle is obvious on physical examination, and biopsy is unnecessary in the vast majority of cases.

Cystoscopy can be performed, either in the office or at the time of excision, to rule out more serious pathologies or when the origin of hematuria is uncertain. Cystoscopy is not necessary when the diagnosis is obvious, hematuria is absent, and no intervention is planned.

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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 below).

This image shows marked vascular engorgement and aThis 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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Contributor Information and Disclosures
Author

Kamran P Sajadi, MD  Assistant Professor, Urology, Oregon Health & Science University

Kamran P Sajadi, MD is a member of the following medical societies: American Urological Association, Endourological Society, and National Association for Continence

Disclosure: Nothing to disclose.

Coauthor(s)

Ann Y Becker, MD  Assistant Professor, Section of Urology, Medical College of Georgia

Ann Y Becker, MD is a member of the following medical societies: American Medical Women's Association, American Urological Association, and Society of Women in Urology

Disclosure: Nothing to disclose.

Scott Rutchik, MD  Assistant Professor, Department of Surgery, Division of Urology, University of Connecticut School of Medicine

Scott Rutchik, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Allen Donald Seftel  MD, Professor of Urology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School; Head, Division of Urology, Director, Urology Residency Training Program, Cooper University Hospital

Allen Donald Seftel is a member of the following medical societies: American Urological Association

Disclosure: lilly Consulting fee Consulting; sanofi-aventis Consulting fee Consulting; auxilium Consulting fee Consulting; solvay Consulting fee Consulting; plethora Grant/research funds clinical trial; endo Consulting fee Consulting; nature publishing journal editor

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mark Jeffrey Noble, MD  Consulting Staff, Urologic Institute, Cleveland Clinic Foundation

Mark Jeffrey Noble, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Kansas Medical Society, Sigma Xi, Society of University Urologists, and Southwest Oncology Group

Disclosure: Nothing to disclose.

J Stuart Wolf Jr, MD, FACS  The David A Bloom Professor of Urology, Director, Division of Endourology and Stone Disease, Department of Urology, University of Michigan Medical School

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Nothing to disclose.

Chief Editor

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Sexual Medicine Society of North America, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Advisor; Astellas Consulting fee Speaking and teaching; Watson Consulting fee Speaking and teaching; Allergan Consulting fee Speaking and teaching

References

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  2. 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].

  3. Indudhara R, Vaidyanathan S, Radotra BD. Urethral tuberculosis. Urol Int. 1992;48(4):436-8. [Medline].

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  5. 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].

  6. 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].

  7. Saroha V, Dhingra KK, Gupta P, Khurana N. Urethral leiomyoma mimicking a caruncle. Taiwan J Obstet Gynecol. Dec 2010;49(4):523-4. [Medline].

  8. Kaneko G, Nishimoto K, Ogata K, Uchida A. A case of intraepithelial squamous cell carcinoma arising from urethral caruncle. Can Urol Assoc J. Feb 2011;5(1):E14-6. [Medline]. [Full Text].

  9. Ozkurkcugil C, Ozkan L, Tarcan T. The effect of asymptomatic urethral caruncle on micturition in women with urinary incontinence. Korean J Urol. Apr 2010;51(4):257-9. [Medline]. [Full Text].

  10. Park DS, Cho TW. Simple solution for urethral caruncle. J Urol. Nov 2004;172(5 Pt 1):1884-5. [Medline].

  11. Martin FM, Rowland RG. Urologic malignancies in pregnancy. Urol Clin North Am. Feb 2007;34(1):53-9. [Medline].

  12. Petersen RO, Stein BS. Genitourinary Pathology. In: Practice of Urology. New York, NY: Norton Medical Books; 1993:48.

  13. 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.

 
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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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