尿道カルンケルの臨床的ならびに組織学的検討

Abstract

The clinical survey on 174 cases of urethral caruncle and histopathological study on 43 cases of them were reported. The incidence was 2.9% of female outpatients and 155 cases of them (89 %) were over 40 years old. Most of them were located along the posterior edge of the external urethral meatus. Acute cystitis was apparently combined in 47 cases of them (26.4 %). Surgical treatment was done on 80 cases and the recurrence was found in 13 cases of them (16.2 %). Although most of them were treated by simple resection of mass with electrocoagulation, we think that excision should be wide enough to include the base of the tumor and deep enough to include the full thickness of the mucous membrane. Trying to classify histologically 43 cases into 4 types according to Momose's classification, namely, epithelial, angiomatous, inflammatory and mixed type, 18 cases were the mixed type and the epithelial type was found in 13 cases. The histological classification of urethral caruncle is very difficult. The regeneration of blood vessels, infiltration of round cells and inflammatory edema in the interstitial tissue were commonly found in almost all of our cases. Therefore, we think that as histological classification, it might be better to divide simply into two types, the epithelial and the connective tissue type, as well as Saito's report. We experienced two cases with malignancy, one transitional cell carcinoma and one precancerous lesion, besides these 174 cases.