Urethral caruncle is best treated by
Correct Answer: Excision followed by repeated dilatation
Description: Excision followed by repeated dilatation A urethral caruncle is a benign red polyp or leison covered by transitional epithelium.deg Usually found on the posterior aspect of the urethral meatus.deg Urethral caruncle is common in postmenopausal female.deg Due to atrophy of vulva and vagina : urethral meatus is exposed to infection. The posterior urethral mucosa becomes swollen, congested and pouts out like a cherry from the posterior wall of external meatus. Symptoms Dyspareuniadeg Post coital bleedingdeg Paindeg Dysuriadeg Investigation :In women complaining of post - menopausal bleeding, other genital malignancies should be ruled out. Management :Friends here there is some confusion : all books mention excision as the best line of management but no where it is mentioned that it is to be followed by repeated dilatation. ''Treatment is by excision and diathermy coagulation of the base of the stalk. The patient should be given antibiotics to treat the underlying chronic urethritis." "Excision biopsy is the definitive surgery. The raw area may be sutured or cauterised. Continous bladder drainage is required for few days." "Treatment is by excision biopsy followed by local or systemic oestrogens." As far as cauterisation is concerned - diathermy is done but chemical cauterisation is not mentioned anywhere. I have given you all references - decide for yourself.
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Gynaecology & Obstetrics
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