Benign gynaecology: urethral caruncle: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Benign gynaecology: urethral caruncle

Sample item

A 65-year-old postmenopausal woman has spotting on wiping and dysuria. Examination shows a small, red, friable, tender polypoid swelling at the posterior lip of the urethral meatus. What is the first-line treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Topical oestrogen cream

A urethral caruncle is a benign, inflamed prolapse of urethral mucosa seen in oestrogen-deficient postmenopausal women. Topical oestrogen and anti-inflammatory measures are the first line, and excision is reserved for persistent, bleeding or suspicious lesions. Biopsy is needed if malignancy is suspected.

Option by option

  • A. Radiotherapy

    Radiotherapy has no place in benign caruncle.

  • B. Cystectomy

    Cystectomy is unnecessarily extreme.

  • C. Topical oestrogen cream (correct)

    Correct. Topical oestrogen treats the underlying atrophy and the caruncle.

  • D. Immediate wide excision of the urethra

    Radical surgery is not indicated for a benign lesion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is C, Topical oestrogen cream. A urethral caruncle is a benign, inflamed prolapse of urethral mucosa seen in oestrogen-deficient postmenopausal women.

Why is "Radiotherapy" not the answer?

Radiotherapy has no place in benign caruncle.

Why is "Cystectomy" not the answer?

Cystectomy is unnecessarily extreme.

Why is "Immediate wide excision of the urethra" not the answer?

Radical surgery is not indicated for a benign lesion.

What concept does this question test?

It tests Benign gynaecology: urethral caruncle in OBG. Topical oestrogen and anti-inflammatory measures are the first line, and excision is reserved for persistent, bleeding or suspicious lesions. Biopsy is needed if malignancy is suspected.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Benign gynaecology: urethral caruncle?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.