Vulva
and Introitus
Biopsy
of the Vulva
Excision
of Urethral Caruncle
Bartholin's
Gland Cyst Marsupialization
Excision
of Vulvar Skin, with Split-Thickness Skin Graft
Bartholin's
Gland Excision
Vaginal
Outlet
Stenosis Repair
Closure
of Wide Local Excision of the Vulva
Wide
Local Excision
of the Vulva, With Primary Closure or Z-plasty Flap
Alcohol
Injection
of the Vulva
Cortisone
Injection
of the Vulva
Merring Operation
Simple
Vulvectomy
Excision
of the
Vulva by the Loop Electrical Excision Procedure (LEEP)
Excision
of
Vestibular Adenitis
Release
of Labial Fusion
Hymenectomy
Excision Of Hypertrophied Clitoris |
Excision of Urethral Caruncle
Urethral caruncles are frequently associated with atrophic
genital epithelium in elderly patients. They can become a source of
chronic hematuria, infection, and urethritis. When medical therapy
with estrogen suppositories and cream does not adequately clear the
lesion, surgical excision is indicated.
The lesion is excised, and
normal urethral mucosa is sutured to the epithelium of the vestibule.
Physiologic Changes. The removal of the inflamed
granulation tissue eliminates a cause of chronic infection and bleeding.
Points of Caution. The operation can frequently
be bloody and, in general, should be performed in an operating room
rather than in an office or clinic.
The need for Foley catheter drainage following removal of the lesion
may be necessary. The application of estrogen cream reduces the risk
of recurrent caruncles.
Technique
The patient is placed in the dorsal lithotomy position, and appropriate
anesthesia is administered (general, regional, or local). The vulva
and perineum are prepped. |
The caruncle is grasped with an
Allis clamp and retracted slightly forward. A scalpel is used to
excise some of the vestibular epithelium and to transect the urethra
proximal to the caruncle. |
The specimen is removed, and the urethral mucosa as well as the
vestibular epithelium is exposed. |
The urethral mucosa is closed to the vestibular
epithelium with interrupted 3-0 synthetic absorbable sutures. |
The urethral mucosa is sutured to the epithelium of the vestibule. |
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