Removal of urethral polyps

Polyps in the urethra are benign neoplasms, the exact cause of which has not been established; however, a number of factors contributing to the development of pathological changes have been identified:

• infection with the human papillomavirus;

• chronic inflammatory diseases of the genitourinary tract (urinary bladder, urethra, and other structures);

• periodic trauma to the urethral mucosa, in particular in cases of frequent catheter placement;

• genetic predisposition;

• leukoplakia of the urinary bladder;

• recurrent urethritis;

• diverticulum (protrusion of the urethral wall);

• sexually transmitted infections (genital herpes, chlamydia, mycoplasmosis, ureaplasmosis, trichomoniasis);

• hormonal imbalance, especially associated with the onset of menopause.

The combination of one or more of the listed factors increases the risk of benign neoplasm formation of the urethral mucosa; therefore, if complaints or risk factors are present, it is recommended to consult a physician in a timely manner for examination.

The urethra, or urinary canal, is a thin tubular organ that ensures the excretion of urine from the urinary bladder to the outside. In men, it is longer, runs inside the penis, and also performs a reproductive function by ensuring the passage of ejaculate. In women, this canal is significantly shorter and anatomically located within the pelvic cavity, opening in the area of the vaginal vestibule.

These anatomical features of the female urethra explain why urethral polyps in women are often detected at early stages and are accompanied by a sensation of a foreign body, burning, or discomfort during urination. In men, symptoms may be less noticeable in the initial stages; however, as the lesion grows, disturbances in urine flow, pain, or the presence of blood in the urine occur more frequently.

Diagnosis of this pathology requires consultation with a urologist, as the symptoms may be similar to those of sexually transmitted diseases. In addition, a urethral polyp must be differentiated from genital warts, which can also grow in this anatomical area and cause similar clinical manifestations.

To establish the diagnosis, it is sufficient to consult a urologist, who will perform a physical examination, take a urethral smear, assess signs of inflammation, and collect the patient’s medical history. The obtained material is sent to a laboratory to identify possible infectious agents. In some cases, additional diagnostic procedures such as cystourethroscopy may be prescribed, allowing the physician to directly visualize the neoplasm.

Removal of polyps from the urethra does not require external incisions or suturing — the procedure is performed endoscopically and is virtually bloodless. An endoscope is inserted into the urethral lumen — a thin flexible tube equipped with a high-resolution video camera and a light source. Inside the device, there is a special channel through which a coagulator is introduced to perform excision.

When working endoscopically, the surgeon obtains detailed visualization of the operative field, can accurately assess the boundaries of the lesion, and perform the procedure, including removal of a urethral polyp in men, taking into account the length and anatomical structure of the urethra. Such procedures are performed using the TUR method — transurethral resection. With this approach, interventions on the urethra, prostate, and urinary bladder are carried out with minimal damage to healthy tissues.

In women, the procedure also has its own anatomical features. Due to the shorter and wider urethra, access to the pathological lesion is technically more convenient, which allows for precise and gentle excision of a urethral polyp in women, with minimal risk of mucosal injury and faster recovery after the procedure.

Removal of urethral polyps using the TUR approach can be performed using several methods:

• laser;

• radiofrequency;

• electrocoagulation.

Coagulation allows the procedure to be performed without significant blood loss. The operation can be carried out on an outpatient basis: the patient comes to the clinic, undergoes the procedure under local anesthesia, and after several hours of observation leaves the medical facility for further recovery at home.

As a result of transurethral resection of the pathological lesion, the urethral lumen is cleared, its patency is restored, and the symptoms that concerned the patient gradually disappear. Complete healing of the mucous membrane may take up to two weeks, during which sexual abstinence is recommended.

To reduce the risk of recurrent changes in the future, several rules should be followed:

• use condoms during sexual intercourse, especially in cases of frequent change of sexual partners;

• timely treatment of infectious and inflammatory processes of the genitourinary system;

• adherence to a healthy lifestyle;

• annual preventive examination by a urologist.

Following these recommendations does not guarantee complete absence of recurrences, but significantly reduces the risk of their occurrence. Removal of a urethral polyp does not require hospitalization, and the minimal invasiveness of the procedure allows a return to a full life in the shortest possible time.