Urethra
General
Benign lesions

Author: Turki Al-Hussain, M.D. (see Authors page)

Revised: 8 November 2017, last major update June 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Urethra benign lesions "loattrfree full text"[sb]

Cite this page: Al-Hussain, T. Benign lesions. PathologyOutlines.com website. http://pathologyoutlines.com/topic/urethrabenign.html. Accessed November 19th, 2017.
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
    Prostatic urethral polyp

    Definition / general:
    • See also Prostate chapter
    • Mostly in adult men
    • Usually asymptomatic but may cause hematuria
    • Cystoscopically, the lesions appear as discrete small papillary growths that may be solitary or extensive, producing a velvety coating on the mucosa


    Microscopic (histologic) description:
  • Papillary fronds contain a thin fibrovascular core and are covered by normal prostatic acinar epithelium
  • Occasionally, foci of residual urothelium can be seen


  • Microscopic (histologic) images:

    Images hosted on other servers:

    Various images