URETHRAL OCCURRENCE OF BLADDER CANCER FOLLOWING CYSTECTOMY

Abstract

Thirty-four male patients with invasive bladder cancer had total cystectomy at our hospital between 1977 and 1982. Of the 28 patients who had not undergone simultaneous urethrectomy, 3 (10.7%) required a subsequent therapeutic urethrectomy for clinically observed urethral carcinoma. The interval between the dates of total cystectomy and delayed urethrectomy in the 3 patients ranged from 12 to 39 months. Two of the 3 patients died of cancer 4 and 28 months after the therapeutic urethrectomy, respectively. The remaining patient had irradiation of 5, 000rads on the small pelvic area as an ajuvant therapy to the urethrectomy. After 45 months of the urethrectomy, he was still alive without any evidence of cancer.
Once the basement membrane is infiltrated, the urethral tumor has access to the vascular corpora and hematogenous dissemination. This may be the major reason why the urethral tumor should be treated multidiciplinarily. In conclusion, a total cystectomy should be accompanied by a prophylactic urethrectomy, because after cystectomy the urethra is functionless and easily neglected area which can give origin to lethal transitional cell carcinoma.