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      The Effect of Asymptomatic Urethral Caruncle on Micturition in Women with Urinary Incontinence

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          Abstract

          Purpose

          The aim of this study was to evaluate the effect of asymptomatic urethral caruncle (UC) on micturition in women suffering from urinary incontinence.

          Materials and Methods

          A total of 232 patients participated in the study. UC was diagnosed in 50 of 232 patients with urinary incontinence during a physical examination in our clinic. All cases were divided into 2 groups: UC combined with urinary incontinence (group 1) and urinary incontinence only (group 2). Urodynamic evaluations were performed according to the International Continence Society standards.

          Results

          Both groups were similar in terms of voiding diary, pad test and residual urine volume. Urodynamic studies revealed no significant difference between group 1 and 2 (infravesical obstruction: 6% vs. 4.4%; overactive detrusor: 44% vs. 42.9% respectively). The rates of severe IPSS (37.8% vs. 20.9%) and severe cystocele (20.9% vs. 13.8%) were numerically higher in group 1 with no statistically significant difference.

          Conclusions

          Our results suggest that there is no effect of asymptomatic UC on lower urinary tract symptoms in women with urinary incontinence. Therefore, treating asymptomatic UC is unnecessary in these patients. However, during incontinence surgery, it is the surgeon's decision whether to treat asymptomatic UC.

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          Most cited references13

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          Primary amelanotic malignant melanoma of the female urethra.

          The case is reported of amelanotic malignant melanoma of the female urethra mimicking urethral caruncle. A 75-year-old woman complained of a mass of the external meatus. Urethral carunclectomy was performed, but histological diagnosis was amelanotic malignant melanoma. Finally, she underwent en block resection of urethra including bladder neck, uterus, adnexa, vagina, and vulva. As urinary diversion, she underwent a continent cathererizable stoma with an appendicovesicostomy, according to the method described by Mitrofanoff, and Y-V graft for reconstruction of the vulva.
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            Urethral caruncle: a herald lesion for distal urethral stenosis?

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              Common lesions of the urethra in women.

              C BURKLAND (1952)
              Urethral disease in women and girls often is overlooked. As the urine may seem to be normal as determined by repeated urinalysis, the symptoms-urinary frequency and burning-may be attributed entirely to other pelvic disease or to functional disorder. Since erroneous diagnosis may lead to unnecessary procedures or to neglect of treatment with consequent development of severe disease in the kidneys or ureters, it is important to consider urethral lesions as a possible cause in any case of abdominal discomfort in women. The most common lesions of the urethra in women are urethritis, stricture, caruncle, inflammatory polyps and cysts, prolapse of the urethra, and diverticulum. In some cases diagnosis can be made simply on the basis of inspection and palpation. In others more extensive diagnostic procedures must be carried out in order that treatment may be definitive. The methods of treatment, varying with the nature of the lesion, are outlined herein.
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                Author and article information

                Journal
                Korean J Urol
                KJU
                Korean Journal of Urology
                The Korean Urological Association
                2005-6737
                2005-6745
                April 2010
                20 April 2010
                : 51
                : 4
                : 257-259
                Affiliations
                Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey.
                [1 ]Department of Urology, Marmara University School of Medicine, Istanbul, Turkey.
                Author notes
                Corresponding Author: Cuneyd Ozkurkcugil. Department of Urology, Kocaeli Universitesi Tip Fak. Umuttepe Kampusu, Kocaeli, Turkey. TEL: +90-532-2951352, FAX: +90-262-3037003, Cuneyd65@ 123456yahoo.com
                Article
                10.4111/kju.2010.51.4.257
                2858849
                20428428
                86448f42-30b7-41e0-9bf7-388cf9bea041
                Copyright © The Korean Urological Association, 2010

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 December 2009
                : 16 March 2010
                Categories
                Original Article
                Voiding Dysfunction

                Urology
                urodynamics,micturition,urethra
                Urology
                urodynamics, micturition, urethra

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