Vulva & female urethra
Female urethra
Benign female urethral lesions


Topic Completed: 1 June 2012

Revised: 9 May 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: urethra benign lesions female
Page views in 2019 to date: 164
Cite this page: Al-Hussain T. Benign female urethral lesions. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/vulvabenignfemaleurethralesions.html. Accessed May 24th, 2019.
Caruncle

Definition / general:
  • Only in female urethra
  • Resembles small raspberry protruding from external urethral meatus
  • Considered a reactive polypoid lesion
  • Patients may be asymptomatic although commonly they experience dysuria, urinary frequency, obstructive symptoms
  • Bleeds easily, may become infected
  • Often recurs, perhaps due to persistence of inciting factors


Treatment:
  • Excision


Microscopic (histologic) description:
  • Three histologic subgroups are described, based on the most prominent component:
    1. Papillomatous
    2. Angiomatous
    3. Granulomatous
  • Highly vascularized fibroblastic connective tissue with chronic inflammation, dilated blood vessels, hyperplastic epithelium
  • Invaginations of urothelium extending into stroma are common, showing rounded nests with cystic or glandular luminal spaces, similar to urethritis cystica / glandularis, without intestinal metaplasia (Hum Pathol 2012;43:1400)


Differential diagnosis:
Diverticula

Definition / general:
  • Usually women, either acquired or congenital
  • In adults, usually secondary to infection, trauma, calculus, obstruction, dilation or inflammation of paraurethral gland
  • Carcinoma may arise in diverticula very rarely


Microscopic (histologic) description:
  • Lined by urothelium, with or without squamous or glandular metaplasia
  • Submucosa is often edematous and inflamed
  • Nephrogenic adenoma may arise in diverticula
Inverted papilloma

Definition / general:
  • Rare in urethra
  • Similar to those in bladder
Leiomyoma

Definition / general:
  • Most common soft tissue tumor of urethra
  • Relatively common in women, rare (< 10 reported) in men


Case report:
  • 48 year old man with quadriplegia (Arch Pathol Lab Med 2000;124:302)
  • Nephrogenic (mesonephric) adenoma

    Definition / general:
    • Metaplastic change, not neoplastic, common in urethra
    • Similar to lesions in bladder neck
    Papilloma

    Definition / general:
    • Rare in urethra
    • Similar to those in bladder
    Polypoid urethritis

    Definition / general:
    • Urethral counterpart of polypoid cystitis


    Microscopic (histologic) images:

    Images hosted on other servers:

    Bladder: broad based papillae lined by normal / reactive urothelium with edematous congested stroma

    Prolapse

    Definition / general:
    • May occur in childhood and simulate a neoplasm
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