Urethral Caruncle Clinical Presentation

Updated: Oct 03, 2022
  • Author: Kamran P Sajadi, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Most urethral caruncles are asymptomatic and are incidentally noted on pelvic examination; however, some may be painful and others may be associated with dysuria. Many individuals with a urethral caruncle present with bleeding or, more commonly, with the patient noticing blood on undergarments or with wiping; this may be mistaken for vaginal bleeding. [6]  

Urethral caruncles are unlikely to explain voiding or storage symptoms in women. In fact, a comparison of lower urinary tract symptoms and urodynamic factors in incontinent women with and without caruncles found no differences. [7] Isolated case reports of urinary retention from urethral caruncle do exist, however. [8]


Physical Examination

On examination, caruncles most often appear clinically as a pink or reddish exophytic lesion at the urethral meatus (see the image below); in rare cases, they are purple or black secondary to thrombosis. Some caruncular lesions may resemble urethral carcinoma.

Urethral caruncles usually protrude posteriorly (at the 6 o'clock position).


Photographs show the preoperative (a) and postoper Photographs show the preoperative (a) and postoperative (b) appearance of a urethral caruncle in a 9-year-old girl. Courtesy of Journal of Medical Case Reports, Springer Nature.