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What Is a Urethral Caruncle?

By Valerie Goldberg
Updated Mar 03, 2024
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A urethral caruncle is a normally benign, red, soft lump found on the posterior of the urethra. Women who have already gone through menopause are more likely to develop these lumps than younger women. Some patients will experience vaginal pain, pain with sex or bleeding from a urethral caruncle, in which case surgery may have to be performed.

Lack of estrogen production and excessive abdominal pressure are two common causes of a urethral caruncle. Some women seem to develop these growths for no apparent reason. It is possible that some patients develop this lump from trauma to the area or from inflammation resulting from back-to-back urinary tract infections.

Some women may develop a urethral caruncle and never know it. Sometimes the caruncle will cause no pain and disappear on its own as mysteriously as it came. Other patients may be in excruciating pain from it. This pain can occur during urination, while sitting or during sexual intercourse. Women experiencing chronic or abnormal urethral pain should make an appointment to see a urologist or gynecologist.

It is important for a doctor to take a look at the urethra of a woman with pain in the area. There are other causes for urethral pain aside from urethral caruncles, including interstitial cystitis, a chronic bladder disease and several sexually transmitted diseases. If a doctor determines that a urethral caruncle is responsible for a woman's pain, then there are several courses of treatment that may work to ease the symptoms. Anti-inflammatory medications or estrogen creams can help to reduce the pain and swelling in the urethra area. The at-home treatment of taking a sitz bath also is typically recommended for patients experiencing discomfort.

Rare cases may occur when a urethral caruncle does not heal on its own. In this scenario, a patient may have to undergo surgery to remove the fleshy lump. The surgery can be done under general or local anesthesia and is normally performed in a hospital rather than a urologist's office. A doctor may prescribe temporary narcotic pain medication while a patient is recovering.

There is always a low possibility that any mass found in the urethral area can cancerous. If a urologist suspects anything unusual about the caruncle, he or she will perform a biopsy. Typically, however, caruncles are benign. Cysts and other hard masses found in the pelvic region are much more likely to be potentially cancerous.

Urethral Caruncle Treatment

Because urethral caruncles are typically benign, treatment is often optional. This is especially true if a patient does not experience any pain. The caruncle will often resolve itself without any medical intervention. Of course, this is not always the case, and there are some circumstances when treatment is necessary. In these instances, there are several options that a doctor may employ.

The first line of treatment is often a regimen of at-home self-care that may include the aforementioned sitz baths and topical anti-inflammatory medication. There is insufficient research to confirm the efficacy of these treatments, but many patients report that they provide relief from symptoms.

If these treatments do not provide relief, however, further intervention may be necessary. Other treatment options include hormone replacement therapy (HRT) to balance the patient’s estrogen levels. Alternately, the caruncle may be removed via one of several surgical methods, including laser vaporization, ligation, or cauterization. These removal methods may be used in combination with other treatment options.

Urethral Caruncle Appearance

Urethral caruncles may be located within the urethra, rendering them invisible to the naked eye. If this is the case, they may only be visible when detected on an ultrasound or other imaging device. If a urethral caruncle is located at the opening of the urethra, however, it may be visible, and it will typically appear as a fleshy mass hanging from the urethral opening.

These growths can reach up to two centimeters in size, though it’s more common to see growths around one centimeter. They typically feature a red or pink color. If a blood clot emerges within the growth, however, it may become a black or purple color. This may cause the growth to bleed, too, if it is left untreated.

The caruncle most often looks like a fleshy protrusion emerging from the urethral opening, and in some cases, it may appear to block the urethra entirely. Though they are extremely uncommon for men, there are rare cases of male urethral caruncles. Men who experience this will likely see a pink or red fleshy protrusion from the head of their penis.

Urethral Caruncle Causes

One of the most common causes of a urethral caruncle is an imbalance of estrogen that commonly affects post- and perimenopausal women. Estrogen is one of the most essential hormones for keeping the skin of the genitals — including the urinary tract — healthy. When there is a deficit of estrogen — as is often the case during and after menopause — it can make a woman vulnerable to dryness and irritation that causes urethral caruncles.

This problem is called urogenital atrophy, and it can lead to other symptoms, too. It can also be caused by a decline in the mucosal lining of the urethra. This is also linked to low estrogen, but there are other hormonal imbalances that may compromise the mucus membrane. It’s important to note that men may develop urethral caruncles as a result of a different cause, but in some cases, male hormonal imbalance may be to blame, too.

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Discussion Comments

By anon1001196 — On Mar 23, 2019

I have a very similar story, painful bleeding and sticking out of my urethra. My urologist wants to do a biopsy and take it out. She said it was a polyp but it looks exactly like what you have explained. Some days it's in and can't see it and when it comes out I feel it right away. Very uncomfortable.

By Sammy1961 — On May 12, 2018

I forgot to add to my comment that the Estradiol cream for urethral caruncle is pretty expensive from $260-$500. Mine was $260, my heath insurance paid $240, I paid $20. Sometimes having very expensive health insurance is worth it.

By anon1000040 — On May 12, 2018

About 2 weeks ago I went to use the bathroom and my urine stream was very weak (stop and go) and I saw blood on the bath tissue.

Everyday, the pain increased and bleeding increased also. After four days of wiping I felt that I had something sticking out of my vagina. I asked my hubby to take a picture and I discovered there is a penny-size, very dark red outgrowth on my inner labia. It looked like I have a baby penis growing from mu vagina.

I went to see my local doctor, and she said I don't see anything. I was “are you kidding me? I even have a picture.” She proscribed me antibiotics, not even knowing what's going on. After four days taking the antibiotics with no improvement and the pain getting worse, I went to see gynecologist and she said, “There is nothing.” I showed her the picture I had, with a 1-inch, dark red bleeding growth sticking from my vagina, and said I even know what it is. I already googled everything and figured it out. Now I need your help to treat it.

I asked if I could use an estrogen cream, because mostly urethra caruncles grow in postmenopausal woman because of low estrogen levels. She said I don't know. Maybe. I will make you an appointment with a urologist. After waiting in pain for three days and no call, and the bleeding increased, I made appointment myself with a urologist. And yes, he said it is a urethral caruncle and proscribed me a Estradiol cream, and said if there's no improvement in three weeks, he can do surgery. In my case, the urethral caruncle is very painful. I can't sit or walk, and it's very painful urinating. Most of the time, I'm in tears and pain.

By anon997325 — On Dec 16, 2016

Get a second opinion. My friend just found out hers is cancer and not good news behind that.

By anon959176 — On Jul 02, 2014

I had several bladder infections with bleeding. I went to the Urologist and was told I had a urethal caruncle and the bleeding was coming from it. I was prescribed Estrace cream. I have been on it for three days, but the cramps and backache are unbearable. I am hoping to get some relief soon. If I don't see some improvement in the next couple of days, I'm going back to the doctor.

By anon269324 — On May 17, 2012

What kind of daily tasks can I do with a urethral caruncle with swelling and bleeding?

By Azuza — On Jul 25, 2011

@ceilingcat - I've never heard of this either. Which is kind of a shame, I think. As women we should be informed about possible problems with our systems, so to speak. I can definitely imagine finding a bump like this and thinking I had contracted an STD or something. I guess that's just another reason why it pays to just go to the doctor instead of trying to diagnose yourself!

By ceilingcat — On Jul 24, 2011

I've never heard of this before. However, I used to get urinary tract infections all the time, so I suppose I was at risk for developing a urethral caruncle. I'm glad I didn't though. Getting two UTIs in a row was bad enough, I can't imaging adding insult to injury with a condition like this!

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