Urethral caruncle causes acute urinary retention

Abstract

Introduction: We encountered a case of urinary retention caused by a urethral caruncle.

Case presentation: An 86-year-old woman presented to our hospital with urinary retention. When the urinary bladder catheter was placed, a smooth, well-defined mass 20 mm in diameter was detected on the posterior wall of the external urethral meatus. The patient was diagnosed with urinary retention due to a urethral caruncle, and the mass was resected. The mass was pathologically compatible with a urethral caruncle. The patient could urinate postoperatively. Ultrasound test after surgery showed residual urine volume was 100 mL.

Conclusion: Inspecting the urethral meatus is vital in the clinical examination of older women with voiding symptoms. A urethral caruncle is a rare cause of urinary retention. However, large urethral caruncles are at risk of causing urinary retention suggesting that resecting the urethral caruncles at an appropriate time is desirable.

Keywords: inspection of urethral meatus; urethral carcinoma; urethral caruncle; urinary retention; women.

Fig. 1

Photographs showing the preoperative appearance of the lesion. (a) Before urinary bladder catheter insertion. The white arrow shows a urethral caruncle. (b) After urinary bladder catheter insertion. The white arrow shows a urethral caruncle.

Fig. 2

Microscopic image of the tumor. (a) The tumor was covered by keratinized squamous epithelium with neutrophilic infiltration. (b) The tumor partially covered with urothelium with erosion. (c, d) Recanalization of organized thrombus was observed in dilated blood vessels. (d: Elastica Masson‐Goldner staining).