Management of the male urethra after cystectomy

Approximately 70,000 new cases of bladder cancer are diagnosed yearly, of which 52,000 are male patients. In 2009 there were approximately 14,000 deaths attributed to bladder cancer, 10,000 of which were men. Approximately 40% to 45% of all cases are high-grade tumors with half of these being muscle-invasive tumors at the time of diagnosis. With the preponderance of men in this population, there is a need for clear management strategies regarding the retained urethra in those men undergoing radical cystectomy. This article reviews the incidence of urothelial carcinoma in the retained urethra, risk factors for the development of urethral urothelial carcinoma, surveillance strategies, treatment modalities, and outcomes following intervention.