A urethral caruncle is a benign outgrowth at the urethral meatus (urethral opening). They occur most commonly in postmenopausal women. Urethral caruncles occur when the outermost part of the urethra everts or turns out. When the mucosa is circumferentially everted, meaning the growth encompasses the entire diameter of the urethra, rather than just a segment of the urethra, the lesion is a urethral prolapse.
Urethral caruncles are often asymptomatic and found on pelvic exam.
Symptoms may include pain, light bleeding, painful urination, or impeded flow of urine. Women may also notice a bump at the urethral meatus.
In asymptomatic patients, treatment is often not necessary. For symptomatic patients, treatment includes vaginal estrogen cream, anti-inflammatory medications such as Motrin, and warm sitz baths.
Surgical excision is recommended for larger, symptomatic caruncles that do not respond to more conservative treatment.