Distal urethral carcinoma: Contemporary management with phallus preserving techniques
J A O'Kelly1, E Browne1, P Murray1
1Department of Urology, University Hospital Waterford, Waterford, Ireland; Royal College of Surgeons in Ireland, Dublin, Ireland.
Summary
This study demonstrates that penile-sparing surgery for primary urethral carcinoma is effective. These techniques preserve the penis and achieve good local control for distal urethral tumors.
Area of Science:
- Urology
- Oncology
Background:
- Primary urethral carcinoma is rare, affecting 1 in a million people in the UK.
- Squamous cell carcinoma is the most common subtype, often linked to Human Papilloma Virus.
- Penile-preserving surgical techniques are recommended for pendulous urethral tumors.
Purpose of the Study:
- To describe the surgical management of seven patients with primary urethral carcinoma.
- To evaluate the feasibility and outcomes of penile-preserving techniques for distal urethral cancers.
Main Methods:
- Seven patients with distal primary urethral carcinoma were identified from a penile cancer database (May 2017 - November 2020).
- Surgical approaches included distal urethrectomy with primary closure, hypospadic neomeatus formation, partial glansectomy with skin graft, and partial penectomy.
- Mean follow-up was 23.4 months.
Main Results:
- Patients presented with visible lesions, lower urinary tract symptoms, or groin masses, with a mean age of 56.5 years.
- Various penile-preserving surgical techniques were employed based on tumor location and extent.
- No disease recurrences were observed during the follow-up period.
Conclusions:
- Penile-preserving surgical techniques are feasible for tumors of the pendulous urethra.
- These techniques appear to provide effective local control for primary urethral carcinoma without compromising oncological outcomes.
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