Villous polyps of the urethra: a report of two cases

Two patients with villous polyps of the prostatic urethra are described. The article supports previous observations that the lesion has the morphologic appearance of prostatic tissue. A review of the literature reveals that this rare lesion appears to be specific for the prostatic urethra and behaves as a benign tumor.

[Urothelial inverse papilloma. Review of the literature (appropos of 2 cases: 1 vesical, the other urethral)]

The authors report two cases of urothelial inverse papilloma and review the 94 observations in the published literature. Some fundamental features of the condition are outlined: 1) DEFINITION: paramalpighian papillary tumor which spreads towards the chorium but does not invade it, and lies under the intact urothelium which is folded towards the lumen of the urinary tract, 2) Site: usually cervicotrigonal but may be urethral; 3) Evolution: usually benign but sometimes recurrent; 4) Histogenesis: abnormal proliferation of Von Brunn's islets. 5) Association: possible with bladder carcinomas.

Genitourinary leiomyomas

Leiomyomas may originate from any anatomic location of smooth muscle in the genitourinary system but are uncommon neoplasms. Five unusual cases of leiomyomas arising from the renal pelvis, bladder, spermatic cord, and glans penis are presented. The leiomyoma arising from the glans penis in a three-year-old boy is the first case of a leiomyoma in that location noted in the literature. A review of leiomyomas from each genitourinary structure of origin is presented.

Fibroepithelial polyp of the verumontanum: a case report and review of the literature

A fibrous polyp of the verumontanum in a 10-year-old boy is described. The diagnosis, treatment and histology are discussed and the literature is reviewed. Perhaps this lesion will be noted more frequently with the availability of improved radiographic and cystoscopic techniques. The treatment has been greatly simplified with the advent of the pediatric resectoscope.

Leiomyoma of the female urethra

Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. There are only 14 documented cases of leiomyoma of the female urethra in the literature. A careful analysis of these cases revealed the average patient age to be 34.1 years. The site of the lesion determined the clinical features and the surgical approach. No common etiological factor could be ascertained. Two additional cases of leiomyoma of the female urethra are reported.

Mucinous urethral caruncle

A case of urethral caruncle, composed exclusively of mucin-secreting colonic-type glands and believed to be the first on record, is described. The lesion presented clinically as an ordinary caruncle and was treated by local excision. The histogenesis of the lesion is discussed, and its probable origin from an intraurethral cloacogenic colonic gland rest is proposed.

Mesonephric adenocarcinoma of the urethra in a woman: report of a case

A case of urethral carcinoma in a 42-year-old woman is reported. The histologic examination of the urethral tumor disclosed mesonephric adenocarcinoma, which is rare in female subjects. The pathology is discussed and the literature is reviewed briefly.

Radiation treatment of primary carcinoma of the female urethra

Because of the rarity of the primary carcinoma of the female urethra, there has been limited experience of individual institutions in management of this disease. Treatment by radiation alone required radium implant skill in early cases and individualized consideration for integrating external and internal irradiation in more advanced cases. From 1961 to 1975 a total of 16 women with histologically verified primary urethral carcinoma were given radiation treatment at the University of Maryland Hospital. Six of 16 patients were primarily treated for palliation only and 10 were receiving curative radiation treatment. The results show an excellent local control in anterior urethral disease (3/3), entire urethral disease (2/3) and urethral disease with involvement of vulva and/or vagina (3/3). Bladder neck, parametrial, inguinal lymph node, or paraortic involvement represents a poor prognosis and failure is close to 100%. Eight of 10 patients who were treated with aggressive radium alone or combination of external irradiation and interstitial therapy show complete control of disease (80%). Total dosage between 5500 to 6500 rad appears to be adequate to control the disease. Palliative treatment by irradiation alone can only offer a short term symptom-free result, and should be considered as an occasional alternative modality of choice.

Urethrographic manifestations of venereal warts (condyloma acuminata)

Intraurethral spread of venereal warts is a serious complication. Urethral involvement may be extensive and is associated with severe irritative symptoms. Spread to the bladder is possible. Recurrence are frequent and eradication difficult. We describe the urethrographic appearance of intraurethral verrucae and believe it to be strongly suggestive of the diagnosis. Voiding cystourethrography is recommended, and satisfactory visualization may be obtained with either voiding or retrograde urethrography. Voiding urethrography following intravenously administered contrast (excretory voiding cystourethrography) is particularly advantageous since it avoids the need for urethral instrumentation and, therefore, cannot contribute to retrograde spread of these contagious growths.

Nephrogenic adenoma in urethral diverticulum

A nephrogenic adenoma located within a urethral diverticulum of a female was found incidental to a diverticulectomy. Cases of this apparently benign lesion have been reported previously, but the lesions were located in the bladder, particularly in older males with a history of chronic cystitis.

Intraurethral thrombosed varix: unusual cause for hematuria

A case of an intraurethral thrombosed vein as a cause for painless hematuria is presented. In contrast to previous reports, the thrombosed varix was located in the midurethra rather than at the urethral meatus. The necessity for biopsy to differentiate from tumor is emphasized.

Pathology and natural history of urethral tumors in females: review of 65 cases

Cancer of the female urethra, although uncommon, is important because unless recognized early and treated adequately, death will ensue, preceded by much morbidity. The authors present a series of 62 patients with 70 primary tumors, and 3 patients with secondary tumors. A comprehensive classification of neoplasms of the female urethra is also included.

Submucosal fibromatosis: prostatism in a young boy?

A seven-year-old boy was seen with a urodynamically significant, obstructing, posterior urethral mass. It was believed to represent either a fibromuscular prostatic enlargement or a nonpedunculated congenital polyp. The differential diagnosis is discussed. Transurethral resection of the mass resulted in decreased voiding pressure and relief of symptoms.

Intraurethral condylomas acuminata: management and review of the literature

We report 4 cases of intraurethral conylomas, the last one representing the first reported successful management of total urethral and intravesical condylomas in a male patient. The literature is reviewed and recommendations for management based on the modalities available are given.

Urethral cytology following cystectomy for bladder carcinoma

There is a high probability of urethral carcinoma in patients who have had cystectomy for carcinoma of the urinary bladder, and their survival is poor when the disease is sufficiently advanced to be symptomatic or tumor is visible endoscopically. This study was undertaken to evaluate urethral cytology as a means of detecting and diagnosing in situ and invasive carcinoma of the urethral remnant following cystectomy. A total of 109 cytology specimens were examined from 65 patients who had cystectomy for bladder cancer. "Positive" or "suspicious" cytologic diagnoses of cancer were made on 28 patients; 24 had urethrectomy and 11 proved to have invasive carcinoma, 10 had carcinoma in situ and three had atypia or metaplastic changes in the urethra. One of 37 patients with "negative" cytologic diagnoses was found to have a low-grade carcinoma. It is suggested that all patients who undergo cystectomy without urethrectomy be followed with urethral cytological examination at regular intervals for an indefinite period.

Granular myoblastoma: perineal neoplasm of probable neural origin

A seventy-year-old man with a painless, perineal neoplasm was found to have a granular cell myoblastoma densely adherent to the bulbar urethra. This case represents the fourth known perineal neoplasm of neural origin.