title: [Diagnosis and treatment of urethral recurrence after radical cystectomy in the male].
abstract: BACKGROUND
  From 4%-6% of males subjected to radical cystectomy due to urothelial carcinoma will have urethral recurrence (UR) during the follow-up.
  
  
  OBJECTIVE
  To analyze the diagnosis, treatment and course of the patients with UR following a cystectomy.
  Analysis of original articles and reviews related with the diagnosis, treatment and course of patients subjected to radical cystectomy and who develop UR. The articles were obtained from a search in PubMed.
  
  
  RESULTS
  Most of the UR appear during the first 3 years of the cystectomy. Approximately 50% of the URs of contemporary series were diagnosed through urethral cytology, the patient being asymptomatic. The urethrectomy is the treatment of choice in patients with UR and cutaneous diversion. In patients with orthotopic bladder replacement (OBR): 1) the treatment of the intraurethral BCG can be useful in patients with carcinoma in situ (CIS), 2) papillary type conservative treatment in UR has contradictory results, 3) when the uretrectomy is necessary, the ileal duct or conversion of the OBR in a continent urinary derivation can be used.
  
  
  CONCLUSIONS
  Urethral cytology is a test having high sensitivity and can contribute to the diagnosis of UR in the earliest stages. In patients with OBR, the diagnosis of a UR is a therapeutic challenge. The bladder tumor, urethral recurrence and presence of an upper urinary tract tumor in 25% of the cases may be a cause of death in these patients.
authors.affiliation: Servicio de Urología, Hospital Clínic, Barcelona, España. Jor_huguet@yahoo.es
authors.forename: J
authors.initials: J
authors.lastname: Huguet
mesh_terms: D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D003584:Cytological Techniques; D004724:Endoscopy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014521:Urethra / Q000473:pathology* / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion