Urethral Hemangiomas: Symptoms and Treatment Options - Urology

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There is a hemangioma near the urethral opening that occasionally causes pain?


Hello Dr.
Du, I have always been cleaning my glans by retracting the foreskin.
However, two months ago, I started having difficulty retracting it, and I noticed a small hard lump (approximately 3mm x 3mm) near the urethral opening.
Occasionally, I experience sharp pain.
I made an effort to retract the foreskin and took a picture of the lump, which appeared dark purple, and showed it to my doctor.
The doctor said that a circumcision was necessary for a proper diagnosis.
I underwent the circumcision last week, and during the procedure, I asked the surgeon about the lump and expressed my concerns about the occasional pain.
The surgeon seemed unconcerned, stating it was a hemangioma and advised not to worry, suggesting that we would address it only if it ruptured.
After the surgery, I was able to see the glans, and I noticed that the hemangioma appears to have nearly doubled in size compared to the photo taken two months ago (6mm x 6mm), and I still experience occasional sharp pain.
What should I do, Dr.
Du?

Hen Kunrao de Ren, 30~39 year old female. Ask Date: 2022/11/02

Dr. Du Shixi reply Urology


Hello: If you are being examined at a medical center and have been seeing a doctor there regularly, you should continue with your scheduled follow-up appointments.
Wishing you good health.

Reply Date: 2022/11/02

More Info


Urethral hemangiomas are vascular tumors that can occur in the urethra, often presenting as small, dark purple or red lesions. They are typically benign but can cause discomfort and other symptoms, as you've described. Given your situation, it’s important to understand the implications of your symptoms and the appropriate steps to take for treatment and management.


Symptoms of Urethral Hemangiomas
The symptoms you are experiencing, such as difficulty retracting the foreskin, pain, and the presence of a hard, dark purple lesion near the urethral opening, are consistent with urethral hemangiomas. These lesions can cause pain or discomfort, particularly if they become irritated or if there is any trauma to the area. The increase in size of the lesion you noted after your circumcision is also concerning and warrants further evaluation.


Treatment Options
1. Observation: In some cases, if the hemangioma is asymptomatic and not causing significant issues, doctors may recommend a watchful waiting approach. However, given your symptoms and the increase in size, this may not be the best option for you.

2. Surgical Intervention: If the hemangioma is causing pain, discomfort, or has increased in size, surgical excision may be necessary. This involves removing the hemangioma and is typically performed under local or general anesthesia. Your surgeon will be able to assess the lesion more accurately during the procedure.

3. Laser Therapy: In some cases, laser treatment can be used to reduce the size of the hemangioma or to remove it. This method is less invasive and can minimize scarring.

4. Follow-Up Care: After any surgical intervention, follow-up appointments are crucial to monitor for recurrence or complications. It’s essential to communicate any ongoing symptoms, such as pain or changes in the lesion, to your healthcare provider.


Next Steps
Given that your hemangioma has increased in size and is causing pain, it is advisable to seek a second opinion or return to your urologist for further evaluation. You should discuss your concerns about the lesion's growth and the pain you are experiencing. It may be necessary to perform imaging studies or a biopsy to confirm the diagnosis and rule out any other conditions.


Lifestyle and Prevention
While there are no specific preventive measures for urethral hemangiomas, maintaining good hygiene and avoiding trauma to the area can help minimize irritation. If you experience any changes in symptoms, such as increased pain, bleeding, or changes in urination, it is crucial to seek medical attention promptly.


Conclusion
In summary, urethral hemangiomas can cause discomfort and may require treatment, especially if they are symptomatic or increasing in size. Given your situation, it is important to follow up with your healthcare provider to discuss your symptoms and potential treatment options. Early intervention can help alleviate discomfort and prevent further complications.

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