Urethral cancer surgery

Urethral cancer Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Surgery is the mainstay of treatment for urethral cancer.

Surgery

Role of Surgery

• Surgery is the mainstay of therapy for urethral cancers in both women and men. The surgical approach depends on tumor stage and anatomic location, and tumor grade plays a less important role in treatment decisions. Although the traditional recommendation has been to achieve a 2-cm tumor-free margin, the optimal surgical margin has not been rigorously studied and is not well defined.
• The role of lymph node dissection is not clear in the absence of clinical involvement, and the role of prophylactic dissection is controversial.
• Radiation therapy and/or chemotherapy may be added in some cases in patients with extensive disease or in an attempt at organ preservation; but there are no clear guidelines for patient selection, and the low level of evidence precludes confident conclusions about their incremental benefit.

• Ablative techniques, such as transurethral resection, electroresection and fulguration, or laser vaporization-coagulation, are used to preserve organ function in cases of superficial anterior tumors, although the supporting literature is scant.

• Surgery is the most common treatment for cancer of the urethra. One of the following types of surgery may be done:

• Open excision surgery
• Electro-resection with flash surgery
• Laser surgery
• Cystourethrectomy surgery
• Cystoprostatectomy surgery
• Anterior body cavity surgery
• Incomplete penectomy surgery
• Basic penectomy surgery