Urethral Caruncle

A urethral caruncle (pronounced “yu-REE-threl” “KAR-uhng-kuhl”) is a small, noncancerous (benign) growth. It grows on the outside of your urethra. It usually sticks out a little on one side. Urethral caruncles aren’t cancer and usually aren’t dangerous.

They happen most often in females who’ve been through menopause. They’re also the most common type of urethral lesion that affects females.

Most of the time, they don’t need treatment. But these growths sometimes look like other, more serious lesions. For this reason, it’s a good idea to talk with a healthcare provider. They can rule out other conditions, like cancer.

What are the symptoms of a urethral caruncle?

In most cases, urethral caruncles don’t cause any symptoms. Most people don’t even know they have one until a healthcare provider finds it during an exam. But sometimes, you may develop symptoms like:

• Bleeding, especially while wiping
• A burning sensation when peeing
• Pain

What does it look like?

Urethral caruncles usually measure 1 to 2 centimeters in diameter. That’s about the size of an aspirin tablet. They also tend to stick out on one edge. They’re usually red or pink. But they can turn black or purple if a blood clot forms.

A urethral caruncle looks similar to a urethral prolapse. But a urethral prolapse looks more like a tiny pink donut. That’s because the prolapse causes your urethra to stick out on all edges.

What is the most common cause of urethral caruncles?

Medical experts aren’t certain what causes urethral caruncles. But you’re at a higher risk if you’ve gone through menopause. Experts believe low estrogen plays a role.

Estrogen keeps the skin in your genital area soft and flexible. When estrogen levels drop, you’re more likely to have dry, thin skin that tears easily. Experts think this is why urethral caruncles are more common after menopause.

Risk factors

Urethral caruncles are most common if you’ve been through menopause. They can also occur before menopause, though it’s not very common.

Urethral caruncles in males are extremely rare.

How doctors diagnose urethral caruncles

Most of the time, healthcare providers detect urethral caruncles during routine pelvic exams. Urethral caruncles may look like other types of urethral growths. These include certain types of cancer, like:

• Lymphoma
• Melanoma
• Sarcoma
• Squamous cell carcinoma
• Urethral cancer
• Urothelial carcinoma

Providers often recommend removing some of the tissue for testing (biopsy). They’ll test the sample to rule out cancer or other conditions. They may also recommend a cystoscopy to look inside your urethra and urinary bladder.

How do you shrink a urethral caruncle?

You don’t need to treat a urethral caruncle unless it’s causing discomfort. Healthcare providers recommend treatment if it affects your quality of life.

The most common urethral caruncle treatments include:

• Anti-inflammatory medications: A provider may recommend creams that you apply to the urethral caruncle. This includes a corticosteroid cream. These medications help ease swelling and irritation.
• Topical estrogen cream: This is a type of hormone replacement therapy that helps restore your estrogen levels.
• Urethral caruncle removal: If other treatments don’t work, a provider may surgically remove a urethral caruncle. Even after surgery, there’s a chance it can come back.

How do you apply estrogen cream?

Follow these steps to apply estrogen cream to a urethral caruncle:

• Wash your hands with soap and water.
• Apply a pea-sized amount of estrogen cream to an applicator or a clean finger.
• Spread the cream over your vaginal and urethral areas. Use your other hand to spread your labia (lips) and apply cream just inside your vagina. It doesn’t need to go far.
• Wash your hands with soap and water again.

Are there home remedies?

Yes. In addition to using topical creams, you can take warm sitz baths. A sitz bath can soothe the area and help ease your symptoms.

Some people also apply petroleum jelly to the caruncle. Petroleum jelly acts as a barrier to help alleviate irritation.

How long does it take to go away?

It depends. You may start to see improvements within six weeks of using a topical estrogen cream. But it may take six months or longer for a urethral caruncle to completely go away. And if you stop treatment, it may grow back.

When should I see my healthcare provider?

Call a healthcare provider right away if you have pain or bleeding around your urethra. You should also reach out if it burns or hurts when you pee.

If a healthcare provider thinks you have a urethral caruncle, you may want to ask:

• Do I need a biopsy to confirm the diagnosis?
• If I need a biopsy, when will I know the results?
• Do you recommend any other types of testing?
• What are my treatment options?
• Will I need surgery?

What can I expect if I have a urethral caruncle?

Your healthcare provider may recommend tests if they think you have one. Tests help rule out more serious conditions, like cancer.

You don’t need treatment unless the growth causes pain or other problems. If it does, your provider will likely prescribe a cream or medications. If those treatments don’t work, you may need surgery.

Is a urethral caruncle the same as a polyp?

No. A urethral polyp is a different type of urethral lesion. It most commonly affects females. Urethral caruncles typically develop after menopause. A urethral polyp is present at birth. Urethral polyps consist of tough tissue. They’re more likely to cause blood in your pee and a urinary blockage. Blockages cause a weak pee stream or completely stop you from being able to pee.