Urethral vestibular polyps

　　The etiology of urethral vestibular polyps has not been clearly elucidated. Since they are more common in postmenopausal women, some reports suggest that insufficient estrogen leading to urethral prolapse may be the first step in the development of urethral vestibular polyps. Local chronic inflammatory stimulation may also lead to urethral inflammation and lesions, thus forming polypoid diseases. Urethral vestibular polyps may also be associated with trichomoniasis, tuberculosis, intestinal ectopia, and fusion of the hymen, but related research is rare. Urethral vestibular polyps are rarely seen in premenopausal and adolescent women.

　　Urethral caruncle is usually very small, but can reach 1-2 cm. It is most common at about 6 o'clock on the posterior lip of the urethral orifice, rare at other parts of the urethral orifice, and extremely rare in the urethra. Most have a wider base, some with a pedicle. Under the microscope, urethral caruncle looks like a granulation tissue bed covered with squamous or transitional epithelium, with a large number of dilated capillaries and fibers. The wrapping of the epithelial tissue can form papillary structures, and inflammatory infiltration is common.

　　The main complications of urethral caruncle are related to women's urinary tract infections and inflammation, including:
　　1. Urethral infection. Cause symptoms such as frequent urination, urgency, and dysuria, which can generally be diagnosed by clinical symptoms and routine urine examination.
　　2. Vulvovaginitis. Lead to increased local secretion, itching discomfort, burning sensation, etc., which can be diagnosed by routine vaginal discharge examination.
　　3. Large caruncle hyperplasia, clothing friction leads to bleeding, secondary infection, etc. Severe cases may lead to normal sexual life.

　　The clinical symptoms of urethral caruncle are as follows:
　　1. Urethral orifice pain:Burning pain may occur, and the pain is exacerbated during urination, activity, clothing friction, and sexual intercourse. Sometimes it can cause frequent urination and scattered urination.
　　2. Contact bleeding:Contact, friction injury is prone to bleeding, but massive bleeding rarely occurs.

　　The preventive measures for urethral caruncle include the following four points:
　　1. Regular physical examination:In order to achieve early detection, early diagnosis, and early treatment.
　　2. Do a good follow-up:Prevent the deterioration of the disease.
　　3. Pay attention to personal hygiene:Keep the perineum clean and dry, change underwear frequently, wear cotton underwear, and have regular gynecological examinations.
　　4. Strengthen physical fitness, improve immunity:Pay attention to the combination of work and rest, participate in physical exercise more often, strengthen nutrition, and take a full nutrition diet with high protein, high carbohydrates, high calories, high vitamins, and low fat.

　　1. Physical examination:Dark red or bright red friable tumor-like tissue can be seen on the posterior wall of the urethral orifice, smooth surface, soft and painful to touch, easy to bleed. Generally 0.5-1.0 cm, with a pedicle or a wider base, some are annular around the urethral orifice.

　　2. Pathological examination:See expanded capillaries, connective tissue and epithelial cells.

　　The diet for urethral caruncle should be light and nutritious. Among them, food therapy is the best dietary choice, which maintains the taste and is also beneficial for the treatment of diseases.
　　Section 1: Astragalus and White茅根 Drink
　　Astragalus 30 grams, white茅根30 grams, Cistanche deserticola 20 grams, watermelon skin 60 grams. Wash the four herbs and place them in a pot, add an appropriate amount of water and boil to a thick juice, then add an appropriate amount of sugar for seasoning. Take 1 dose per day, divided into 2 servings, which can benefit the spleen, warm the kidneys, diuretic and relieve stranguria.
　　Second, Lycium barbarum and Poria cocos tea
　　50 grams of Lycium barbarum, 100 grams of Poria cocos, appropriate amount of black tea. Grind Lycium barbarum and Poria cocos into coarse powder for later use. Take 10 grams of coarse powder each time, add an appropriate amount of black tea, infuse with boiling water to drink as tea. Strengthen the spleen and kidney, promote diuresis and relieve stranguria.
　　Third, kidney-nourishing porridge
　　1 pig kidney, 100 grams of malva verticillata leaves, 50 grams of glutinous rice. Clean and cut the pig kidney into fine pieces, first decoct malva verticillata leaves to get juice, then add pig kidney and glutinous rice, cook into porridge. Take one dose a day, divide into two servings, eat warm, can benefit the spleen and kidney, promote diuresis and relieve stranguria.
　　Fourth, lotus honey drink
　　100 milliliters of fresh lotus juice, 30 milliliters of white honey, 60 milliliters of raw rehmannia juice. Mix the above three juices, simmer over low heat for 10-15 minutes. Take 10 milliliters each time, 4 times a day, slowly swallow, take for 3 days. It can nourish Yin and clear heat, cool blood and stop bleeding.
　　Fifth, celery stewed with Diancang
　　15 grams of Diancang, 60 grams of fresh celery. Boil Diancang with a small amount of water first, then add celery to cook together, add seasonings when eating. Nourish Yin and calm the liver, clear heat and promote diuresis.

　　The Western medicine treatment for urethral meat boss includes drug treatment and surgical treatment, specifically including:
　　First, drug treatment
　　Appropriate supplementation of estrogen levels in the body is of great help to the treatment of the disease. Estrogen cream can be used externally, with good effects. For those with senile vaginitis, estrogen vaginal suppositories can be used, once a day, for 10-20 days. Then once every 1-2 weeks until complete cure.
　　Second, surgical treatment
　　For patients with long-term urethral meat boss that does not heal, electrocautery, cryosurgery, laser or surgical resection can be performed. The surgical resection should include the base and the incision should be sutured. Generally, needle ablation technique is adopted, the introduction is as follows:
　　1. Operation process:
　　Using a radiofrequency ablation instrument, insert the ablation needle into the meat boss to the base, the depth of insertion is determined according to the size of the meat boss, generally 0.3-1.0cm, the power is controlled within the range of 6-15W, and the ablation time is 10-30 minutes. For those with a wide base or meat boss surrounding the urethra, ablation can be performed at two or more points, and the bottom of the extended urethra should be fully exposed, and needle ablation can be performed under direct vision or under urethroscope.
　　2. Criteria for completion of treatment:
　　Stop treatment when the pale area reaches the entire meat boss.