The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

Abstract

PurposeThe aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence.Materials and MethodsA total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards.ResultsBoth groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference.ConclusionsOur results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC.

A Rare Cause of Urinary Retention in Women: Urethral Caruncle

“…After almost three centuries of identification, its etiopathogenesis is still not fully illuminated. Many factors such as recurrent infections, chronic irritation, estrogen insufficiency and chronic inflammatory diseases with chronic granulation tissue formation are blamed for its etiology 4,9 . Histologically, urethral caruncles could have papillomatous, angiomatous or granulomatous morphology.…”

“…On the other hand, hyperplastic areas could be observed on the surface epithelium. However, it could also be observed that the surface epithelium forms cystic or glandular structures as a result of its invagination into sub-epithelium stromal areas 9,10 . Previous studies mentioned that malignancy could be encountered postoperatively, albeit rarely.…”

“…The effectiveness of these treatment approaches is limited and does not allow histopathological evaluation of lesions. Surgical excision of lesions that become symptomatic or reach to large dimensions is a treatment strategy accepted by many authors 2,3,9 . Similarly, urethral caruncle was surgically excised in our case and the urethral obstruction caused by it was obliterated.…”

Urethral caruncle in a young pregnant woman: an uncommon cause of urethral overgrowth

“…However, pain, and dysuria may occur and few patients may seek consultation for bleeding from the lesion after noticing staining of undergarments. Urinary retention has been reported but storage or voiding abnormalities are not observed in urodynamic studies [4]. Tumors occur in about 2% of urethral caruncles and intraepithelial squamous cell carcinoma has been reported arising within the urethral caruncle [5].…”