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Miki J, Fukuokaya W, Taoka R, Saito R, Matsui Y, Hatakeyama S, Kawahara T, Matsuda A, Kawai T, Kato M, Sazuka T, Sano T, Urabe F, Kashima S, Naito H, Murakami Y, Nishiyama N, Nishiyama H, Kitamura H, Kimura T. Oncological outcomes of prophylactic urethrectomy at the time of radical cystectomy for bladder cancer: A nationwide multi-institutional study. Int J Urol 2024. [PMID: 38822533 DOI: 10.1111/iju.15505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/19/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES To determine the effects of prophylactic urethrectomy (PU) on oncological and perioperative outcomes in patients with bladder cancer (BC) undergoing radical cystectomy (RC). METHODS This retrospective study analyzed data on 1976 evaluable patients with BC who underwent RC. Patients were drawn from 36 institutions within the Japanese Urological Oncology Group. Oncological outcomes were compared using restricted mean survival times (RMSTs) based on inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves for non-urinary tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Interaction terms within IPTW-adjusted Cox regression models were examined to assess the heterogeneity of treatment effect based on the risk of urethral recurrence (UR). The association between PU, estimated blood loss (EBL), and the incidence of severe postoperative surgical complications (SPSCs) (Clavien-Dindo grade 3 or higher) was analyzed. RESULTS Of 1976 patients, 1448 (73.3%) received PU. IPTW adjustment was used to balance baseline characteristics between the treatment groups. Within the 107-month window of patient monitoring, PU showed no survival benefits (NUTRFS difference: 0.2 months [95% confidence interval: -6.8 to 7.3]; CSS, 1.2 [-4.9 to 7.3]; OS, 0 [-6.5 to 6.5]). No significant interactions were observed with factors associated with UR, and PU was associated with unfavorable perioperative outcomes (EBL, 1179 mL vs. 983 mL; SPSC, 14.6% vs. 7.0%). CONCLUSIONS This study showed that (1) PU was not associated with survival in patients with BC undergoing RC, regardless of UR-associated factors, and (2) PU was associated with unfavorable perioperative outcomes.
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Affiliation(s)
- Jun Miki
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Wataru Fukuokaya
- Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Rikiya Taoka
- Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Ryoichi Saito
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiyuki Matsui
- Department of Urology, National Cancer Center Hospital, Tokyo, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Takashi Kawahara
- Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Ayumu Matsuda
- Department of Urology, National Cancer Center Hospital, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Minoru Kato
- Department of Urology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Tomokazu Sazuka
- Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeshi Sano
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Fumihiko Urabe
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Soki Kashima
- Department of Urology, Akita University Graduate School of Medicine, Akita, Japan
| | - Hirohito Naito
- Department of Urology, Kurashiki Central Hospital, Okayama, Japan
| | - Yoji Murakami
- Department of Urology, Graduate School of Life Science, Kumamoto University, Kumamoto, Japan
| | - Naotaka Nishiyama
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroshi Kitamura
- Department of Urology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Takahiro Kimura
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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Subiela JD, González-Padilla DA, Huguet J, Aumatell J, Rodríguez-Faba O, Krajewski W, Feliu AH, Mínguez C, Plaza JL, Artiles Medina A, Gajate P, Jiménez Cidre MÁ, Burgos Revilla J, Breda A, Palou J. Oncological and Renal Function Outcomes in Patients Who Underwent Simultaneous Radical Cystectomy and Nephroureterectomy for Synchronous or Metachronous Panurothelial Carcinoma. Urology 2023; 172:157-164. [PMID: 36436672 DOI: 10.1016/j.urology.2022.08.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess clinical outcomes of patients who underwent simultaneous radical cystectomy (RC) and radical nephroureterectomy (RNU) for panurothelial carcinoma (PanUC). MATERIALS AND METHODS A retrospective analysis of 67 patients who underwent simultaneous RC and unilateral RNU for PanUC, from 1996 to 2017. Kaplan-Meier estimates for remnant urothelium recurrence-free survival, metastasis-free survival, overall survival (OS), and cancer-specific survival (CSS) were performed. Cox multivariate models were constructed. RESULTS The median follow-up was 38 months, 29.8% of patients had a recurrence, 34.3% had metastasis, 67.2% of patients died from any cause, and 37.3% died from urothelial carcinoma. Overall survival and CSS rates at 5 years were 44% and 61%, respectively. In multivariate analysis, progression to muscle-invasive bladder cancer before surgery, presence of muscle-invasive stages at RC and/or RNU, and prostatic urethra involvement were predictors for worse metastasis-free survival and CSS. Forty-one patients (61.2%) had an estimated glomerular filtration rate (eGFR) <60 mL/min before surgery and the number rose to 56 (83.5%) after surgery; 29.8% patients needed renal function replacement therapy after surgery (16 haemodialysis and 4 renal transplant). CONCLUSION Patients with PanUC who undergo simultaneous surgery have adverse oncological (only 4 out of every 10 remain alive at 5 years) and functional outcomes (1 out of 3 will need renal function replacement therapy after surgery). Up to a third of the patients had a recurrence (urethra or contralateral kidney) within 18 months, justifying close surveillance or considering prophylactic urethrectomy. These data should help in counsel on morbidity and life expectancy.
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Affiliation(s)
- José Daniel Subiela
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain.
| | | | - Jorge Huguet
- Urooncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona; Department of Surgery, Barcelona, Spain
| | - Júlia Aumatell
- Urooncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona; Department of Surgery, Barcelona, Spain
| | - Oscar Rodríguez-Faba
- Urooncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona; Department of Surgery, Barcelona, Spain
| | - Wojciech Krajewski
- Department of Urology and Oncological Urology, Department of Public Health, Wrocław Medical University, Wrocław, Poland
| | | | - Cesar Mínguez
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - José López Plaza
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Alberto Artiles Medina
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Pablo Gajate
- Medical Oncology Department, Hospital Ramón y Cajal, IRYCIS and CIBERONC, Madrid, Spain
| | - Miguel Ángel Jiménez Cidre
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Javier Burgos Revilla
- Department of Urology, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcala, Madrid, Spain
| | - Alberto Breda
- Department of Urology, Clínica Universidad de Navarra, Madrid, Spain
| | - Joan Palou
- Department of Urology, Clínica Universidad de Navarra, Madrid, Spain
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Laukhtina E, Moschini M, Soria F, Andrea DD, Teoh JYC, Mori K, Albisinni S, Mari A, Krajewski W, Cimadamore A, Abufaraj M, Enikeev D, Neuzillet Y, Giannarini G, Xylinas E, Kamat AM, Roupret M, Babjuk M, Witjes JA, Shariat SF, Pradere B. Follow-up of the Urethra and Management of Urethral Recurrence After Radical Cystectomy: A Systematic Review and Proposal of Management Algorithm by the European Association of Urology-Young Academic Urologists: Urothelial Carcinoma Working Group. Eur Urol Focus 2022; 8:1635-1642. [PMID: 35337773 DOI: 10.1016/j.euf.2022.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/20/2022] [Accepted: 03/07/2022] [Indexed: 01/25/2023]
Abstract
CONTEXT Surveillance of the urethra and management of urethral recurrence (UR) after radical cystectomy (RC) is an area with poor evidence. OBJECTIVE We aimed to summarize the available evidence and provide clinicians with practical recommendations on how to prevent and manage UR after RC for bladder cancer. EVIDENCE ACQUISITION The MEDLINE and EMBASE databases were searched during September 2021 for studies evaluating UR after RC. The primary endpoint was oncologic outcomes for patients who experienced UR depending on different surveillance and management approaches. EVIDENCE SYNTHESIS Forty-three studies were included in the quantitative synthesis. According to the currently available literature, a tight-knitted surveillance protocol should be implemented for males treated with RC and nonorthotopic neobladder diversion as well as patients with prostatic involvement, tumor multifocality, bladder neck involvement, and concomitant carcinoma in situ. A survival benefit of a prophylactic urethrectomy has been reported only in patients at very high risk for UR based on clinical factors. Surveillance protocols were highly heterogeneous and poorly documented among included studies. Patients whose UR was diagnosed based on clinical symptoms had a poor prognosis. Only limited data were available on the comparative effectiveness of watchful waiting after RC versus clinical symptom screening as part of a follow-up strategy. However, the use of regular cytology and/or urethroscopy seems useful in select patients at high risk for UR. Despite limited data on the optimal management of UR, urethra-sparing approaches (transurethral resection of UR) seem to be an option for Ta (only) recurrences; a salvage urethrectomy with or without chemotherapy should be the standard for all others. CONCLUSIONS Based on the currently available literature, we have proposed an algorithm to guide the decision-making process to help identify and treat UR after RC. Given the lack of evidence on how to deal with UR and surveil patients at risk for UR, this study may invigorate research in this area of unmet need. PATIENT SUMMARY Early diagnosis and tailored management of urethral recurrence could help improve oncologic outcomes in these patients.
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Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Marco Moschini
- Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Torino, Italy
| | - David D Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Simone Albisinni
- Service d'Urologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wroclaw, Poland
| | - Alessia Cimadamore
- Section of Pathological Anatomy, Marche Polytechnic University, School of Medicine, United Hospitals, Ancona, Italy
| | - Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Yann Neuzillet
- Department of Urology, Hôpital Foch, UVSQ-Paris-Saclay University, Suresnes, France
| | - Gianluca Giannarini
- Urology Unit, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Evanguelos Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Ashish M Kamat
- Department of Urology, M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Morgan Roupret
- GRC n°5, Predictive Onco-Urology, Ap-Hp, Urology, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Marko Babjuk
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic
| | - J Alfred Witjes
- Department of Urology, Radboud University, Nijmegen Heyendaal, The Netherlands
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
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Fasanella D, Marchioni M, Domanico L, Franzini C, Inferrera A, Schips L, Greco F. Neobladder "Function": Tips and Tricks for Surgery and Postoperative Management. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081193. [PMID: 36013372 PMCID: PMC9409805 DOI: 10.3390/life12081193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022]
Abstract
Orthotopic neobladder (ONB) reconstruction is a continent urinary diversion procedure increasingly used in patients with muscle-invasive bladder cancer following radical cystectomy (RC). It represents a valid alternative to the ileal duct in suitable patients who do not prefer a stoma and are motivated to undergo adequate training of the neobladder. Careful patient selection, taking into account the absolute and relative contraindications for ONB as well as an adequate recovery protocol after surgery are integral to the success of this procedure and the oncological and functional outcomes. The objective of this review is to summarize the current data on RC with ONB in terms of patient selection, preoperative preparation, surgical techniques and functional (continence and sexual activity) and oncological outcomes, with particular attention to the management of complications and the impact on quality of life (QoL).
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Affiliation(s)
- Daniela Fasanella
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University of Chieti, SS Annunziata Hospital, 66100 Chieti, Italy
| | - Michele Marchioni
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University of Chieti, SS Annunziata Hospital, 66100 Chieti, Italy
| | - Luigi Domanico
- Urology Unit, Centro Salute Uomo, Via Palma il Vecchio 4a, 24122 Bergamo, Italy
| | - Claudia Franzini
- Urology Unit, Centro Salute Uomo, Via Palma il Vecchio 4a, 24122 Bergamo, Italy
| | - Antonino Inferrera
- Urology Unit, Centro Salute Uomo, Via Palma il Vecchio 4a, 24122 Bergamo, Italy
| | - Luigi Schips
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University of Chieti, SS Annunziata Hospital, 66100 Chieti, Italy
| | - Francesco Greco
- Urology Unit, Centro Salute Uomo, Via Palma il Vecchio 4a, 24122 Bergamo, Italy
- Correspondence: ; Tel.: +39-3317918535
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Morizane S, Honda M, Yumioka T, Iwamoto H, Hikita K, Takenaka A. Technique of en bloc resection of the membranous urethra and bladder during robot-assisted radical cystectomy in patients without simultaneous urethrectomy. Asian J Endosc Surg 2022; 15:683-687. [PMID: 35114733 DOI: 10.1111/ases.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/03/2022] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Prophylactic urethrectomy is often performed simultaneously with radical cystectomy (RC) in patients who are not selected for neobladder creation for urinary diversion. However, the indications for prophylactic urethrectomy are still controversial. Here, we introduce the ideal urethral dissection technique during robot-assisted radical cystectomy (RARC) in patients without simultaneous prophylactic urethrectomy. MATERIALS AND SURGICAL TECHNIQUE At our hospital, RARC is performed using a da Vinci surgical system with the operating table tilted to 20°. After lymph node dissection and bladder mobilization, periurethral dissection is commenced. A notable point of our technique is en bloc resection of the bladder and membranous urethra using a continuous intracorporeal approach. First, while applying traction on the isolated bladder in the cranial direction, we carefully and gradually dissect the urethral smooth muscle from the external urethral sphincter with electrocautery scissors. Next, we ligate the membranous urethra with suture material as far from the prostate as possible. Then, we cut the urethra as far from the prostate as possible after ligation of the urethra with a Hem-o-lok clip just beyond the apex of the prostate. Using this method, we are able to remove at least 1.0 cm of the membranous urethra en bloc with the bladder. Finally, we suture the pelvic floor, including the levator ani muscle, in two layers using 3-0 V-Loc and 2-0 V-Loc sutures. DISCUSSION We believe this technique allows separation of the residual urethra from the abdominal cavity and enables safe performance of secondary urethrectomy.
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Affiliation(s)
- Shuichi Morizane
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Masashi Honda
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tetsuya Yumioka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Hideto Iwamoto
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Katsuya Hikita
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
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Laukhtina E, Boehm A, Peyronnet B, Bravi CA, Batista Da Costa J, Soria F, D'Andrea D, Rajwa P, Quhal F, Yanagisawa T, König F, Mostafaei H, Enikeev D, Ingels A, Verhoest G, D'Hondt F, Mottrie A, Joniau S, Van Poppel H, de la Taille A, Bensalah K, Bruyère F, Shariat SF, Pradere B. Urethrectomy at the time of radical cystectomy for non-metastatic urothelial carcinoma of the bladder: a collaborative multicenter study. World J Urol 2022; 40:1689-1696. [PMID: 35596017 PMCID: PMC9236994 DOI: 10.1007/s00345-022-04025-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/13/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The optimal management of the urethra in patients planned for radical cystectomy (RC) remains unclear. We sought to evaluate the impact of urethrectomy on perioperative and oncological outcomes in patients treated with RC for non-metastatic urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS We assessed the retrospective data from patients treated with RC for UCB of five European University Hospitals. Associations of urethrectomy with progression-free (PFS), cancer-free (CSS), and overall (OS) survivals were assessed in univariable and multivariable Cox regression models. We performed a subgroup analysis in patients at high risk for urethral recurrence (UR) (urethral invasion and/or bladder neck invasion and/or multifocality and/or prostatic urethra involvement). RESULTS A total of 887 non-metastatic UCB patients were included. Among them, 146 patients underwent urethrectomy at the time of RC. Urethrectomy was performed more often in patients with urethral invasion, T3/4 tumor stage, CIS, positive frozen section analysis of the urethra, and those who received neoadjuvant chemotherapy, underwent robotic RC, and/or received an ileal conduit urinary diversion (all p < 0.001). Estimated blood loss and the postoperative complication rate were comparable between patients who received an urethrectomy and those who did not. Urethrectomy during RC was not associated with PFS (HR 0.83, p = 0.17), CSS (HR 0.93, p = 0.67), or OS (HR 1.08, p = 0.58). In the subgroup of 276 patients at high risk for UR, urethrectomy at the time of RC decreased the risk of progression (HR 0.58, p = 0.04). CONCLUSION In our study, urethrectomy at the time of RC seems to benefit only patients at high risk for UR. Adequate risk assessment of UCB patients' history may allow for better clinical decision-making and patient counseling.
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Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Axelle Boehm
- Department of Urology, University Hospital of Tours, Tours, France
| | - Benoit Peyronnet
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Carlo Andrea Bravi
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Jose Batista Da Costa
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Torino School of Medicine, Turin, Italy
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Frederik König
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Alexandre Ingels
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Gregory Verhoest
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Frederiek D'Hondt
- Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Alexandre Mottrie
- Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | | | - Alexandre de la Taille
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Karim Bensalah
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Franck Bruyère
- Department of Urology, University Hospital of Tours, Tours, France
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France.
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Mehrnoush V, Ismail A, Zakaria A, Elmansy H, Shahrour W, Prowse O, Kotb A. Micropapillary bladder cancer: an added indication to prophylactic urethrectomy. J Surg Case Rep 2021; 2021:rjab501. [PMID: 34804485 PMCID: PMC8598118 DOI: 10.1093/jscr/rjab501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/19/2021] [Indexed: 11/14/2022] Open
Abstract
There is little research on the role of urethrectomy during cystectomy in patients with micropapillary bladder cancer (MPBC). We present two cases of MPBC cystectomy and suggest that urethrectomy be performed concurrently as a preventive measure. The first case involved a woman who had a mixed solid and papillary bladder tumour. An anterior pelvic exenteration was performed as well as a total urethrectomy. The T4a micropapillary variant tumour was confirmed by pathology. The second case involved a man with T1 MPBC who was treated with a BCG induction course. A recurrent muscle-invasive MPBC was discovered during follow-up. During the radical cystoprostatectomy, the urethra was spared. T2 MPBC was discovered through pathology. He had a urethrectomy 6 months later due to urethral bleeding, and the pathology revealed micropapillary cancer of the urethra.
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Affiliation(s)
- Vahid Mehrnoush
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Asmaa Ismail
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Ahmed Zakaria
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Hazem Elmansy
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Walid Shahrour
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Owen Prowse
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
| | - Ahmed Kotb
- Department of Urology, Northern Ontario School of Medicine, TBRHSC, 980 Oliver Road, Thunder Bay, Ontario, P7B 6V4, Canada
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