A urethral caruncle is a polyp in the urethra. This disease affects only women. Neoplasm occurs mainly after menopause. At young and children's age the caruncle is noted extremely seldom. Pathology can be asymptomatic for a long time. Often, a polyp in the urethra is detected by chance during an examination by a gynecologist. Such polyps are benign. However, under adverse conditions, tumor cells can regenerate. This is fraught with the occurrence of urethral cancer. Therefore, caruncle must be treated in a timely manner.
What is this?
Caruncle of the urethra in women is a round tumor on a short and wide stalk. The neoplasm consists of a mucous membrane and contains many vessels. This is a small tumor, its size is usuallyonly 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 may be purple or black. In shape, this neoplasm is similar to a ring. A photo of a urethral caruncle can be seen below.
Usually a polyp forms on the back wall at the bottom of the urinary canal. Therefore, the tumor is easily detected during a gynecological examination.
Reasons
Most often, caruncle of the urethra 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 increases.
There are other adverse factors that can trigger the appearance of a caruncle:
- Injuries of the urethra. Wounds in the urethra can form during the passage of stones, after childbirth or sexual intercourse. As they heal, connective tissue grows and polyps may appear.
- Infections. In chronic cystitis or urethritis, the tissues of the urinary tract are constantly irritated by bacterial toxins. This can provoke the appearance of benign neoplasms in the canal.
- Common diseases. Urethral caruncle often occurs in patients with diabetes mellitus and autoimmune pathologies. These diseases reducethe body's resistance to infections and adversely affect metabolism. As a result, the urethral mucosa may undergo pathological changes.
Usually, the appearance of a polyp requires exposure to several adverse factors. Age-related changes in the urethra are aggravated 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 discovered by chance during a routine examination. Most of the patients at the initial stage have no complaints and the process of urination is not disturbed.
However, as the polyp grows, the following pathological manifestations occur:
- bleeding from urethra;
- frequent urge to urinate;
- pain and burning in the urethra (especially when urinating);
- difficulty in passing urine;
- cloudy color of urine;
- frequent cystitis and urethritis.
When the tumor grows up 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 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. Whereinweakness, 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 a chronic delay in the outflow of urine create a favorable environment for the reproduction 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 caruncle. In advanced cases, the polyp can turn 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 nearby lymph nodes increase.
Diagnosis
A polyp is usually detected during a gynecological examination. This neoplasm is often located in the lower urethra and is clearly visible.
The patient needs a consultation with a urologist. You must also pass the following examinations:
- Urine analysis for bacteria (bakposev). Such a study is prescribed for a polyp complicated by cystitis or urethritis.
- A blood test for estrogens. A drop in the level of female hormones is one of the main reasons for the formation of a tumor.
- 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 tissue is examined under a microscope. It helps in timeidentify malignancy of the caruncle of the urethra in a woman. 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, as well as from varicose veins in the genital area.
Conservative treatment
If the caruncle is small and does not cause discomfort to the patient, then doctors recommend dynamic monitoring. In this case, a woman needs to regularly visit a gynecologist and a urologist. Specialists will monitor the condition and growth of the polyp.
In menopause, hormonal treatment of caruncle of the urethra is carried out. Prescribe drugs with estrogens:
- "Klimonorm";
- "Klimadinon";
- "Premarin";
- "Klimara";
- "Ovestin".
These drugs are substitution therapy. They help replenish the deficiency of female hormones and stop the growth of the polyp.
They also use local remedies (creams) with estrogens:
- "Estrace";
- "Estrogel";
- "Ogen";
- "Estraderm".
To relieve pain and inflammation, drugs are prescribed in the form of ointments:
- "Levomekol";
- "Cycloferon";
- "Viferon".
If caruncle is accompanied by cystitis or urethritis,antibiotics are indicated. The choice of drug depends on the results of a urinalysis for bacteremia.
Operation
If the tumor is large and causes discomfort to the patient, then 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 urethral caruncle in women are extremely rare. Reviews of the operation indicate that the majority of patients did not experience re-growth of the tumor. However, a good result of treatment is possible only if the cause of caruncle formation is simultaneously eliminated. Therefore, in the postoperative period, it is necessary to take drugs to normalize hormonal levels and relieve inflammation.
Prevention
To prevent the occurrence of caruncle of the urethra, it is necessary to regularly undergo preventive examination by a gynecologist. This is especially importantfor women aged 45-50 years, as such patients are at risk. The specialist will be able to diagnose the polyp at an early stage and treat it in time.
If a doctor recommends that a woman undergo hormone replacement therapy during menopause, then it is necessary to take the prescribed medications regularly. This will help normalize estrogen levels and prevent the formation of polyps in the urethra.
