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Overview

The urethra is a membranous tube that connects to the bladder and its function is to facilitate the flow of urine from the bladder to the outside of the body. In men, its other function is to carry semen and sperm from the prostate and testes.

Sometimes, benign (non-cancerous) lesions/masses may grow in the urethra as a result of infections, trauma, and even due to birth defects.

These will be discussed further together with treatment protocols to manage the lesions.

Urethral stricture disease

Scar tissue that forms in the urethra due to persistent infections such as STIs can result in narrowing of the urethra. Symptoms of the condition include an increased frequency to urinate, decreased urine flow, bleeding, urinary tract infections, and inflammation of the prostate.

Depending on the severity of the structure, the condition will be managed either with dilatation of the urethra by inserting specialized equipment into the organ or performing surgery to either cut through the stricture (urethrostomy) or remove the damaged part of the urethra and replace it with a graft or part of the foreskin (urethrectomy).

Genital warts

Human papillomavirus (HPV) is a virus that is associated with the development of genital warts in humans. The warts usually develop on the shaft of the penis but in some cases, they may grow in the urethra.

Masses in the urethra will usually be surgically removed by a urologist.

Urethral polyps

These are rare lesions that often appear at birth and have an irregular growth pattern. They occur more commonly in females and are made up of fibrous tissue together with smooth muscle or nerve tissue that is covered with a thin membrane. Symptoms of polyps include the appearance of a lump in the vulva of the vagina, urinary obstruction, and blood in the urine.

A cystoscopy is performed where the urethra is visualized with a small, flexible camera and slender instruments are used to remove the polyps.

Urethral caruncle

These masses look like polyps except they seem to hang from a stalk in the urethra. The condition is most commonly seen in women who don't use hormone replacement therapy after menopause. Symptoms include tenderness at the outlet of the urethra, a reddish piece of tissue sticking out of the opening of the urethra, a sudden and increased need to urinate, and painful urination.

If these caruncles don't cause any symptoms then they don't need to be managed further. If they are symptomatic though, estrogen creams or ointments can be used and if they are big they can be removed while performing a cystoscopy.

Paraurethral cyst

These cysts are located in females in the wall of the vagina near the urethra. Symptoms include feeling a lump near the urethra and it can cause misdirected urination, urinary obstruction, and pain while urinating.

These cysts can be left alone if they don't cause any symptoms and they usually resolve on their own. If they cause symptoms or urinary obstruction, the cysts can be drained by piercing them.

Urethral prolapse

This is a rare condition of the female urethra but more problematic than the other mentioned lesions. The membrane and spongy tissue of the urethra stick out of the opening of the organ. This occurs most often in younger females and it can cause pain and vaginal bleeding.

The prolapsed tissue is surgically removed and the membrane is sutured back into place to prevent it from prolapsing again.

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