Urethral Caruncle A urethral caruncle is a benign lesion seen on the female urethra.  They typically occur in post-menopausal women.  They are usually small and have no symptoms.  In severe cases they may present with spotting of blood in the underwear or may be felt as a mass on the outside of the urethra.  On exam they may appear as a red bump on the urethra.  They are not typically painful, however can rarely thrombose and become painful.                 They are usually diagnosed on pelvic exam.  Treatment is generally conservative using sitz baths, vaginal estrogens and anti-inflammatories.  In cases of large or painful lesions surgical excision may be required.  This is typically done under a light sedation and will include a cystoscopy (scope in the bladder) and a foley catheter for a short period of time.  Healing is usually quick although there is a small risk of stenosis or narrowing of the urethra.