Detection of urethral carcinoma using a soluble swab

Experience with primary carcinoma of the male urethra

We reviewed 23 cases of primary carcinoma of the male urethra and compared the clinical findings, treatment and results to the experiences previously reported. Patients with lesions of the pendulous urethra managed by appropriate amputation of the penis with ilio-inguinal node dissection for groin metastases had a good prognosis, whereas patients with lesions of the bulbo-membranous or prostatic urethra had a poor prognosis. Despite occasional successful results with conservative surgical excision and over-all poor results with radical excision the generally extensive nature of such tumors necessarily makes radical excision the treatment of choice.

Transitional cell carcinoma of the urethra in men having cystectomy for bladder cancer

Charcteristics of urethral transitional cell carcinoma in patients who have undergone cystectomy for bladder cancer have been reviewed. The retained urethra was the site of urothelial malignancy in 7 per cent of 348 patients who underwent cystectomy alone. Urethras removed during prophylactic cystourethrectomy in 110 patients showed unsuspected carcinoma in situ and marked atypic in 12.5 per cent. Patients with urethral cancer were at greater risk for meatal and upper tract tumors, a reflection of multicentric tumor neogenesis, and at greater risk for perineal tumors and inguinal metastases, a reflection of direct invasion. Cytology is advocated for examining the retained urethra. However, urethrectomy to include a fossa navicularis and glandular meatus at the time of cystectomy seems justified as a definitive means of guarding against the often asymptomatic and potentially lethal urethral occurrences of transitional cell carcinoma. Furthermore, incontinuity removal of the bladder and urethra more nearly satisfies the requirements for cancer surgery by avoiding transection of a tumor containing viscus.