Excision of a urethral caruncle is a minor surgical procedure performed to remove a small, benign, red or pink fleshy lesion arising from the posterior lip of the urethral meatus, most commonly seen in postmenopausal women.
The procedure is typically carried out under general anaesthetic as a day case.
A circumferential or elliptical excision of the caruncle is performed with careful haemostasis and closure using fine absorbable sutures. If indicated, the excised tissue is sent for histopathological analysis.
Indications include:
Symptomatic caruncles causing bleeding, discomfort, dysuria, or urinary frequency
Suspicion of malignancy or atypical features on examination
Failure of conservative treatment with topical oestrogen or anti-inflammatories
Postoperative care includes:
Gentle hygiene with plain water in the shower (no soaps or gels)
Mild oral analgesia for discomfort
Avoidance of sexual activity and heavy physical exertion for 2–4 weeks
Review of histology results at follow-up
The procedure is generally well tolerated with minimal downtime. Recurrence is uncommon, though may occur if underlying hormonal atrophy is not addressed.
