Sonoda Kento, Kato Rika, Kojima Hajime, Tokuda Yasuharu
Family Medicine, Teine Family Medicine Clinic, Sapporo, Japan.
General Internal Medicine, Muribushi Okinawa for Teaching Hospitals, Okinawa, Japan.
BMJ Case Rep. 2019 Feb 25;12(2):e225540. doi: 10.1136/bcr-2018-225540.
A 69-year-old Japanese woman with a post-hysterectomy status came to our primary care clinic. She presented with vaginal bleeding for the past 3 days which had developed after defecation. There was a palpable mass measuring approximately 2 cm on pelvic exam; however, heavy bleeding prevented in-depth observation. CT and MRI scans revealed that the mass was inside the urethral meatus and not in the vagina. She underwent surgical resection of the urethral tumour, and the pathological report showed no malignancy. A final diagnosis of urethral caruncle was made. Vaginal bleeding is commonly encountered in the primary care practice and is usually attributed to gynaecological diseases. However, patients and physicians may falsely regard urinary or gastrointestinal tract bleeding as one involving the genital tract. We present a case wherein vaginal bleeding was initially considered but was later identified to be due to a urethral caruncle.
一位69岁子宫切除术后的日本女性来到我们的初级保健诊所。她在过去3天出现排便后发生的阴道出血。盆腔检查可触及一个约2厘米的肿块；然而，大量出血妨碍了深入观察。CT和MRI扫描显示肿块位于尿道口内而非阴道内。她接受了尿道肿瘤的手术切除，病理报告显示无恶性病变。最终诊断为尿道肉阜。阴道出血在初级保健实践中很常见，通常归因于妇科疾病。然而，患者和医生可能会错误地将泌尿系统或胃肠道出血视为涉及生殖道的出血。我们报告了一例最初被认为是阴道出血，但后来被确定是由尿道肉阜引起的病例。
