The urethral caruncle is a polyp in the urethra. This disease affects only women. Neoplasm occurs mainly after menopause. In young and childhood, caruncles are extremely rare. Pathology can be asymptomatic for a long time. Often a polyp in the urethra is detected accidentally during an examination by a gynecologist. Such polyps belong to benign formations. However, under adverse conditions, tumor cells can degenerate. This can lead to urethral cancer. Therefore, the caruncle must be treated in a timely manner.
What it is?
The urethral caruncle in women is a round tumor on a short and wide leg. The neoplasm consists of a mucous membrane and contains many vessels. This is a small tumor, its dimensions are usually only a few millimeters, in rare cases reaching a diameter of 1-1.5 cm. The polyp has a soft structure and a reddish color. When squeezing the legs, the color of the neoplasm can be purple or black. In form, this neoplasm is similar to a ring. A photo of the urethral caruncle can be seen below.
Typically, a polyp forms on the back wall in the lower part of the urinary canal. Therefore, the tumor is easily detected by a gynecological examination.
Causes
Most often, the urethral caruncle is formed during menopause. This is due to changes in the hormonal background in the female body. During menopause, the level of estrogen decreases, which leads to a deterioration in the elasticity of the tissues of the urethra and its prolapse (prolapse). Because of this, the mucosa is often injured. Cells undergo degenerative changes. As a result, the risk of polyps is increased.
There are other adverse factors that can trigger the appearance of a caruncle:
- Urethra injuries. Sores in the urethra can form during the passage of stones, after childbirth or sexual intercourse. When they heal, connective tissue grows, and polyps can appear.
- Infections In chronic cystitis or urethritis, urinary tract tissues are constantly irritated by bacterial toxins. This can trigger the appearance of benign tumors in the canal.
- Common diseases. Urethral caruncle often occurs in patients with diabetes mellitus and autoimmune pathologies. These diseases reduce the body's resistance to infections and adversely affect metabolism. As a result, the mucous membrane of the urethra can undergo pathological changes.
Typically, the occurrence of a polyp requires exposure to several unfavorable factors. Age-related changes in the urethra are exacerbated by injuries, infections, as well as autoimmune and endocrine pathologies.
Symptoms
As already mentioned, this disease can occur for a long time without pronounced symptoms. A polyp is often detected accidentally during a routine inspection. At the initial stage, most patients have no complaints and the urination process is not disturbed.
However, as the polyp grows, the following pathological manifestations occur:
- discharge of blood from the urethra;
- frequent urination;
- pain and burning in the urethra (especially when urinating);
- difficulty urine outflow;
- turbid color of urine;
- frequent cystitis and urethritis.
When the tumor grows to 1-1.5 cm, the patient may experience discomfort even when wearing underwear. A foreign body is felt in the urethra. Cystitis and urethritis are severe, with weakness, chills, and a sharp increase in temperature.
Complications
How dangerous is the urethral caruncle? Without treatment, a polyp in the urethra can lead to serious complications:
- Anemia If the polyp is accompanied by frequent bleeding, then the patient's hemoglobin level drops. In this case, weakness, fatigue and frequent dizziness are noted. This condition develops with a long duration of the disease.
- Purulent cystitis and urethritis. Polypous formations in the urethra and chronic delay in the outflow of urine create a favorable environment for the propagation of pathogenic bacteria. Therefore, inflammatory processes in the urinary tract are often accompanied by suppuration.
- Malignant degeneration of tumor cells (malignancy). This is the most dangerous complication of the caruncle. In advanced cases, the polyp can go into urethral cancer. A sign of such a formidable disease is an increase in bleeding from the urethra. In the future, the patient's pain increases, the urethra becomes edematous, and the nearby lymph nodes increase.
Diagnostics
The polyp is usually detected during a gynecological examination. This neoplasm is often located in the lower parts of the urethra and is clearly visible.
The patient needs a consultation with a urologist. You must also undergo the following examinations:
- Analysis of urine on bacteria (bacterial sowing). Such a study is prescribed for a polyp complicated by cystitis or urethritis.
- Blood test for estrogen. A drop in female hormones is one of the main causes of tumor formation.
- Endoscopic examination of the urethra. This procedure allows you to examine the tumor in detail if the polyp is located deep in the canal.
- Biopsy. A small piece of the polyp is taken for examination and the tissues are examined under a microscope. This helps in time to detect malignancy of the urethral caruncle in women. A photo of the histological picture with a polyp can be seen below.
These studies make it possible to distinguish a polyp from cancerous tumors, papillomas, and also from varicose vessels in the genital area.
Conservative treatment
If the caruncle is small and does not cause patient discomfort, then doctors recommend a dynamic observation. In this case, a woman needs to visit a gynecologist and a urologist regularly. Specialists will monitor the condition and growth of the polyp.
In the menopause, hormonal treatment of the urethral caruncle is performed. Prescribe drugs with estrogen:
- Klimonorm;
- Klimadinon;
- Premarin;
- Klimara
- "Ovestin."
These drugs are substitution therapy. They help make up for the deficiency of female hormones and stop the growth of the polyp.
Local agents (creams) with estrogens are also used:
- Extrace;
- Estrogel;
- "Fire";
- Estraderm.
To relieve pain and inflammation, preparations are prescribed in the form of ointments:
- Levomekol;
- Cycloferon;
- Viferon.
If the caruncle is accompanied by cystitis or urethritis, then antibiotics are indicated. The choice of drug depends on the results of a urine test for bacterial inoculation.
Operation
If the tumor is large and causes patient discomfort, surgical removal of the polyp is indicated. This operation is carried out by the following methods:
- Cryodestruction. The tumor is exposed to liquid nitrogen. This leads to the destruction of its cells. In rare cases, such surgical intervention is complicated by purulent urethritis.
- Laser cauterization. The polyp is destroyed by high temperatures and radiation. After this operation, there are practically no negative consequences.
- Excision. Under general or local anesthesia, the polyp is removed using surgical instruments. This operation is effective, but traumatic. After surgery, bleeding from the urethra, swelling of the tissues, narrowing of the lumen of the urethra are possible.
After surgery, relapses of the urethral caruncle in women are extremely rare. Reviews of the operation indicate that most patients did not experience re-growth of the tumor. However, a good treatment result is possible only if the cause of the formation of a caruncle is simultaneously eliminated. Therefore, in the postoperative period, it is necessary to take drugs to normalize the hormonal background and relieve inflammation.
Prevention
To prevent the appearance of a caruncle of the urethra, it is necessary to regularly undergo a routine examination by a gynecologist. This is especially important for women aged 45-50 years, as such patients are at risk. A specialist will be able to diagnose a polyp at an early stage and conduct treatment on time.
If the doctor recommends a woman to undergo hormone replacement therapy during the menopause, then you must regularly take the prescribed medication. This will help normalize estrogen levels and prevent the formation of polyps in the urethra.