Recurrent Postcoital Hematuria. A Case of Fibroepithelial Urethral Polyp in an Adult Female

Abstract

Introduction In males, an isolated gross postcoital hematuria is a very rare clinical phenomenon. No cases of postcoital macroscopic hematuria have been previously reported in females. Aim To report a case of female urethral fibroepithelial polyp (FEP) associated with recurrent postcoital hematuria. Methods A young (31 years old), eumenorrheic woman complained of three episodes of postcoital macrohematuria. The patient was assessed with a detailed history, with a bimanual pelvic examination and with bidimensional and tridimensional ultrasonographic and color Doppler analyses of the internal genitalia and of the urethrovaginal space. Main Outcomes Measures Transvaginal two-dimensional (2-D) ultrasonographic evaluation of internal genitalia, bladder and urethra and three-dimensional (3-D) analysis of the urethra and paraurethral structures. Results The 2-D transvaginal evaluation and the 3-D reconstruction showed a polypoid hypervascularized structure arising from the anterior urethral wall. A cystourethroscopy confirmed the presence of a FEP arising from the anterior wall of the urethra and allowed its removal. Conclusions A gross postcoital hematuria may be associated with a urethral polyp. The ultrasonographic evaluation of the urethrovaginal space can facilitate the diagnosis.

Urethral Polyp Causing Dysuria in a Young Woman

“…The translabial ultrasonographic evaluation of the urethra and the periurethral space may be a multidisciplinary, adequate, easy, cheap, fast, and non-invasive. We did not found any other lesion in our patient [4]. Magnetic resonance imaging can accurately diagnose a wide spectrum of urethral, periurethral abnormalities and provide a road map for surgeons, dynamic MRI allows functional assessment of urethral mobility [5].…”

Fibroepithelial urethral polyp with minor prostatic glands in an older man

“…Most of these polyps in adults are asymptomatic,2 as in the present case. Although hematuria and urinary obstruction have been reported in patients with fibroepithelial urethral polyps,4 5 the clinical symptoms of fibroepithelial urethral polyps are non-specific as other obstructing urethral lesions, such as urethral valve, stricture and lithiasis, show similar symptoms 1. There has been no reports of malignant tumours arising from fibroepithelial urethral polyps and recurrence 2.…”

Evaluation and management of urethral and periurethral masses in women

“…Diagnosis in adulthood is rare but has been described in case reports (e.g. 31-year-old woman with postcoital hematuria; 61-year-old woman with refractory urinary retention) [33,34]. Transurethral polyp excision was performed in both cases with excellent symptom resolution.…”