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What are Some Types of Benign Urethral Lesions in Boys?

Urethral Polyps

A urethral polyp is a rare, irregular growth that most often appears at birth. It's often made up of fibrous tissue. It may also include some smooth muscle, small cysts, or nerve tissue, all covered with a thin protective layer of tissue.

Meatal Stenosis

Meatal stenosis
Meatal Stenosis

Meatal stenosis is when the hole at the penis tip is very small. This is caused by irritation around the hole. The irritation can lead to tissue growth and scarring across the hole. Meatal stenosis is most common in circumcised males, and seldom occurs in uncircumcised males. For more information on meatal stenosis please visit our comprehensive Urologic Conditons article.

Congenital Urethral Fistula

A urethral fistula is an abnormal passage ("fistula") between the urethra and the outside of the penis. It's called congenital when it occurs during growth before birth. The passage opens under the normal urethral hole at the end of the penis. During urination, two streams of urine may be seen. One will come from the urethral opening at the tip of the penis, and the other from the abnormal hole. The urologist often finds this condition by physical exam and watching the urination. This condition is rare.

Diverticulum of the Anterior Urethra

Diverticula are pouch-like enlargements of the lower urinary tract. They can happen in both the bladder and the urethra. Diverticula in the urethra make it wider.

This type of lesion can appear in 2 forms:

Saccular

This is the less severe condition. The diverticula rise from the floor of the urethra. This causes a weak urine stream, straining, and blocked urine flow. In some cases, the urethra can swell during urination.

Megalourethra

This is a more severe form, where the whole urethra is affected. There are 2 subsets of this condition:

Scaphoid megalourethra

This type of lesion happens when the spongy tissue (corpus spongiosum) around the urethra in the penis is missing.

Fusiform megalourethra

This lesion happens when both the corpus spongiosum and corpora cavernosa (the chambers that support the penis) are missing. In this case, the whole penis swells into a spindle-like form during urination.

The most common cause of urethral diverticulum is surgery that involves the urethra (such as for hypospadias). The urethra narrows downstream from the diverticulum. This raises the pressure in the urethra, causing the weak urethral tissue to balloon.

Cowper's Duct Cyst

Cowper's glands (also known as bulbourethral glands) are found under the prostate gland. These pea-sized glands make a clear, colorless fluid before ejaculation. This fluid cleans the urethra and neutralizes acid to protect sperm. It also provides a small amount of lubrication for sex. Cowper's duct cysts occur due to abnormal narrowing at the opening into the urethra.

Urethral Duplication

Urethral duplication is a rare condition where a person is born with 2 urethras. It can be a complete copy of the organ with 1 or 2 openings, or just an extra urethra with a joined opening.