Urethral Caruncles: A Review of the Literature

Background: Urethral caruncles are benign lesions of the distal urethra which have been most commonly described in post-menopausal women. Over the years, urethral caruncles had been described in women. However, in 2012, Karthikeyan and associates [1] reported a urethral caruncle in a male. Urethral caruncles resemble a variety of urethral lesions including: urethral carcinoma; urethral diverticulum; urethral prolapse; peri-urethral gland abscess. Objectives: To review the literature on urethral caruncles including: the aetiology, pathophysiology, presentation, investigation and management. Results: Urethral caruncles quite often originate from the posterior lip of the urethra and they are described as: fleshy out-growths of the distal urethral mucosa. Urethral caruncles are usually small but may grow as large as 1 cm to 2 cm in diameter. A variety of lesions have been reported that mimicked urethral caruncles and some of these include: melanoma of urethra, tuberculosis, urethral leiomyoma, malignancy arising in a urethral caruncle. Conservative treatment is the treatment of choice for most cases of urethral caruncle. This includes: warm sitz-baths, topical oestrogen creams, topical anti-inflammatory drugs. Surgical treatment is reserved for (a) large symptomatic lesions, (b) cases in which conservative treatment has failed to relieve symptoms, (c) cases of uncertain diagnosis. Complications occurring after excision of urethral caruncle include recurrence, meatal retraction and stenosis. Conclusions: Urethral caruncles are a fairly common disease, and most cases can be t reated conservatively. Nevertheless, carcinoma arising from the urethral caruncle or urethral carcinoma resembling a urethral caruncle has only been occasionally reported. The patient’s condition should therefore, be carefully monitored when using conservative therapy for the management of urethral caruncle. Refractory or large caruncles and caruncles with un-usual appearances should be treated aggressively surgically and carefully assessed for the presence of any malignancy or other types of inflammatory lesions including tuberculosis. Introduction Urethral caruncles, which quite often originate from the posterior lip of the urethra, are described as fleshy out-growths of the distal urethral mucosa. Urethral caruncles are usually small but may grow as large as 1 cm to 2 cm in diameter [2]. Literature on urethral caruncles has been reviewed in this paper including a discussion of various reported cases on urethral caruncles.