Urethral masses are one of the symptoms of urethral cancer. Urethral cancer can be detected by vaginal palpation, and vaginal examination can reveal thickened and hardened urethral masses and stripes. Vaginal examination can reveal the size, texture and mobility of the lesion, and vaginal double examination can reveal the presence of bladder and pelvic metastases. About 50% of urethral cancers are secondary to metastatic epithelial carcinoma of the bladder, ureter or renal pelvis. Primary urethral cancer is relatively rare and occurs mainly in women. The cause of urethral cancer is not clear, but it is not related to the possibility of occurrence of urethral caruncle. Urethral white spots may be pre-cancerous lesions, and urethral cancer is similar to urethral caruncle, polyps and papilloma in early stage, which should be differentiated and biopsied when necessary. Lower and middle urethra cancer may be diagnosed by visual or palpation examination. The lesion may appear as a bright red papillary bulge towards the urethral lumen and urethral orifice, which is easily misdiagnosed as urethral caruncle with a misdiagnosis rate of about 8%. Urethral neoplasm should also be differentiated from acute and chronic inflammatory lesions such as urethral mucosal prolapse and diverticula. Urethral carcinoma can be detected by vaginal palpation. Vaginal examination can reveal thickened and hardened urethral masses and striated masses. Vaginal examination can reveal the size, texture and mobility of the lesion, and vaginal double examination can reveal the presence of bladder and pelvic metastases. When the lesion invades into the vaginal wall, it is difficult to determine whether the primary focus comes from the urethra or from the vagina itself cystourethroscopy and biopsy are the main methods to diagnose urethral cancer.