Clinical application of transurethral resection/electrocautery for urethral hemangiomas: two centers retrospective cohort study
DOI:
https://doi.org/10.2340/sju.v61.45577Keywords:
Urethral hemangiomas, transurethral resection, transurethral electrocautery, recurrence; complicationsAbstract
Background: We aimed to evaluate the safety and efficacy of transurethral resection/electrocautery for the treatment of urethral hemangiomas.
Methods: A retrospective analysis was conducted on clinical data from patients who underwent transurethral resection/electrocautery for urethral hemangiomas at two medical institutions between August 2018 and July 2025. Perioperative data, short-term and long-term complications, and tumor recurrence were assessed.
Results: In total, 42 patients were included in this study. All patients successfully underwent surgical treatment without any intraoperative complications and residual tumor. The procedures were completed in a median operative length of 10 min (interquartile range [IQR]: 10–15 min) and a median blood loss volume of 20 mL (IQR: 10–20 mL). Most patients (n = 39, 92%) presented multiple lesions, with a median size of 4 mm (IQR: 3–4 mm). The lesion range of the 31 patients (74%) was more than one-half of the circumferential diameter in cystourethroscopy. Postoperative complications occurred in five patients (12%), primarily consisting of difficult urination (n = 4, 10%) and gross hematuria (n = 1, 2%). The median follow-up times were 12.0 months (IQR: 8.0–38.5 months), and one patient developed recurrence 4 months after surgery. Long-term complications, such as urethral stricture, urinary incontinence, and retrograde ejaculation, were observed.
Conclusion: Transurethral resection/electrocautery provides a safe, effective, and feasible treatment for urethral hemangiomas, delivering swift hemostasis with very low rates of complications and recurrence. Although this study included the largest sample size currently available worldwide, the findings still need additional validation.
Downloads
References
Saito S. Posterior urethral hemangioma: one of the unknown causes of hematuria and/or hematospermia. Urology. 2008;71(1):168.e111–168.e164.
https://doI.org/10.1016/j.urology.2007.09.058 DOI: https://doi.org/10.1016/j.urology.2007.09.058
Han H, Zhou XG, Fan DD, et al. An unusual etiology for hematospermia and treatments that were successful. Urology. 2015;86(4): 740–743.
https://doI.org/10.1016/j.urology.2015.06.031 DOI: https://doi.org/10.1016/j.urology.2015.06.031
Regragui S, Slaoui A, Karmouni T, et al. Urethral hemangioma: case report and review of the literature. Pan Afr Med J. 2016;23:96.
https://doI.org/10.11604/pamj.2016.23.96.8700 DOI: https://doi.org/10.11604/pamj.2016.23.96.8700
Liao LG, Li YF, Zhang Y, et al. Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology. Sci Rep. 2019;9(1):5018.
https://doI.org/10.1038/s41598-019-41123-2 DOI: https://doi.org/10.1038/s41598-019-41123-2
Mahmoudnejad N, Mohammadi Torbati P, et al. Female urethral cavernous hemangioma: introducing treatment and follow-up course of three cases. Urol Int. 2024;108(2):159–162.
https://doI.org/10.1159/000535464 DOI: https://doi.org/10.1159/000535464
Li CC, Li CZ, Yen CH, et al. Urethral hemangioma in a prepubertal female patient: report of a rare case. Medicine (Baltimore). 2017;96(13):e6502.
https://doI.org/10.1097/MD.0000000000006502 DOI: https://doi.org/10.1097/MD.0000000000006502
Zhou M, Lin J, Wei JH, et al. Misdiagnosis of hematuria after catheterization: a case report and literature review of posterior urethral hemangioma in a pediatric male. Urol Case Rep. 2025;60:102901.
https://doI.org/10.1016/j.eucr.2024.102901 DOI: https://doi.org/10.1016/j.eucr.2024.102901
Varea-Malo R, Campos-Juanatey F, Portillo Martin JA, et al. Multiple urethral hemangiomas associated with urethral stricture: an uncommon aetiology for urethral bleeding. Case Rep Urol. 2019;2019:9071327.
https://doI.org/10.1155/2019/9071327 DOI: https://doi.org/10.1155/2019/9071327
Suh Y, Gandhi J, Joshi G, et al. Etiologic classification, evaluation, and management of hematospermia. Transl Androl Urol. 2017;6(5):959–972.
https://doI.org/10.21037/tau.2017.06.01 DOI: https://doi.org/10.21037/tau.2017.06.01
Parshad S, Yadav SP, Arora B. Urethral hemangioma. An unusual cause of hematuria. Urol Int. 2001;66(1):43–45.
https://doI.org/10.1159/000056564 DOI: https://doi.org/10.1159/000056564
Huang ZM, Li YF, Wang Q, et al. Clinical characteristics and endoscopic treatment of hematospermia with postcoital hematuria. BMC Urol. 2020;20(1):78.
https://doI.org/10.1186/s12894-020-00646-x DOI: https://doi.org/10.1186/s12894-020-00646-x
de Leon JP, Arce J, Gausa L, et al. Hemangioma of the prostatic urethra: holmium laser treatment. Urol Int. 2008;80(1):108–110.
https://doI.org/10.1159/000111741 DOI: https://doi.org/10.1159/000111741
Soleimani MJ, Shadpour P, Mehravaran K, et al. Laser treatment for urethral hemangiomas: report of three cases. Urol J. 2017;14(3):3094–3099.
Efthimiou I, Kavouras D, Vasilakis P, et al. Hemangioma of penile urethra-treatment with simple transurethral excision: a case report. Cases J. 2009;2:6199.
https://doI.org/10.4076/1757-1626-2-6199 DOI: https://doi.org/10.4076/1757-1626-2-6199
Genov P, Conkova E, Hristova I, et al. A rare case of urethral hemangioma treated with LASER. Urol Case Rep. 2022;43:102067.
https://doI.org/10.1016/j.eucr.2022.102067 DOI: https://doi.org/10.1016/j.eucr.2022.102067
Bissada NK, Frangos DN, Ferentzi C. Management of extensive urethral hemangiomas with endoscopic sclerotherapy: case report. J Urol. 1994;151(4):1015–1016.
https://doI.org/10.1016/S0022-5347(17)35154-6 DOI: https://doi.org/10.1016/S0022-5347(17)35154-6
Murray WJ, Fletcher MS, Walters HL, et al. Treatment of urethral hemangioma by selective arterial embolization. J Urol. 1986;136(6):1304–1306.
https://doI.org/10.1016/S0022-5347(17)45323-7 DOI: https://doi.org/10.1016/S0022-5347(17)45323-7
Kardar A, Sundin T, Linjawi TA. Urethral hemangioma managed with sclerotherapy. Case report. Scand J Urol Nephrol. 1994;28(4):435–437.
https://doI.org/10.3109/00365599409180529 DOI: https://doi.org/10.3109/00365599409180529
Terada N, Arakaki R, Okada Y, et al. Management of urethral hemangiomas associated with Klippel-Trenaunay-Weber syndrome by endoscopic sclerotherapy. Int J Urol. 2007;14(7):658–660.
https://doI.org/10.1111/j.1442-2042.2007.01571.x DOI: https://doi.org/10.1111/j.1442-2042.2007.01571.x
Furuya S, Ogura H, Tanaka Y, et al. Hemangioma of the prostatic urethra: hematospermia and massive postejaculation hematuria with clot retention. Int J Urol. 1997;4(5):524–526.
https://doI.org/10.1111/j.1442-2042.1997.tb00299.x DOI: https://doi.org/10.1111/j.1442-2042.1997.tb00299.x
Ikeda J, Taniguchi H, Inoue M, et al. Urethral hemangioma treated with transurethral coagulation using narrow-band imaging: a case report. Cureus. 2025;17(4):e82791.
https://doI.org/10.7759/cureus.82791 DOI: https://doi.org/10.7759/cureus.82791
Efesoy O, Cayan S, Akbay E. Novel algorithm for the management of hematospermia. Turk J Urol. 2022;48(6):398–405.
https://doI.org/10.5152/tud.2020.20428 DOI: https://doi.org/10.5152/tud.2020.20428
Santosa KB, Tirtayasa PMW, Yudiana IW, et al. Urethral cavernous hemangioma in female: surgical resection and reconstruction with ventral vaginal graft urethroplasty. Urol Case Rep. 2019;23:52–54.
https://doI.org/10.1016/j.eucr.2018.12.008 DOI: https://doi.org/10.1016/j.eucr.2018.12.008
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jian-Feng Huang, Rong-Hua Wu, Jin-Chun Qi, Tao Guo, Fan He, Yan-Yang Jin, Liang Liu

This work is licensed under a Creative Commons Attribution 4.0 International License.
As from Volume 59 (2024) all published articles, unless otherwise specified, are published under CC-BY license, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, with the condition of proper attribution to the original work.

