Urethrectomy in men with transitional cell carcinoma of bladder.
Data on a selected group of 90 male patients who had total cystectomy for diffuse transitional cell carcinoma encroaching on the bladder neck and/or involving the prostatic urethra were studied in relation to the incidence of urethral involvement. Of the 59 patients who had only total cystectomy, 8 (13.5%) required a subsequent therapeutic urethrectomy for clinical anterior urethral carcinoma. Of the remaining 31 patients who underwent simultaneous prophylactic urethrectomy at the time of cystectomy, 2 (6.4%) had transitional cell carcinoma and 1 had moderate mucosal atypia of the anterior urethra. Although the remaining urethra constitutes a potential hazard for further tumor formation, only 1 of 10 patients with urethral carcinoma possibly died of urethral tumor recurrence. Therefore, the urologist has a choice either to follow the patient closely with cytologic urethral wash or to do a prophylactic urethrectomy, especially in patients who are difficult to follow-up closely.
D002278:Carcinoma in Situ / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D008679:Metaplasia; D009364:Neoplasm Recurrence, Local; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D011379:Prognosis; D014521:Urethra / Q000473:pathology / Q000601:surgery*; D014523:Urethral Neoplasms / Q000150:complications* / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000601:surgery