Clinical application of transurethral resection/electrocautery for urethral hemangiomas: two centers retrospective cohort study.

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.