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Related Experiment Videos

Selective urethrectomy following cystoprostatectomy for bladder cancer.

D P Hickey, M S Soloway, W M Murphy

    The Journal of Urology
    |October 1, 1986
    PubMed
    Summary

    Prophylactic urethrectomy after cystoprostatectomy for bladder cancer is often unnecessary. Urethral wash cytology effectively identifies patients needing urethrectomy, avoiding unnecessary surgeries for many.

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    Area of Science:

    • Urology
    • Oncology

    Background:

    • Symptomatic urethral carcinoma post-cystoprostatectomy has a poor prognosis.
    • Prophylactic urethrectomy is debated due to overtreatment and exclusion of advanced diversion techniques.

    Purpose of the Study:

    • To evaluate the efficacy of urethral wash cytology in detecting urethral carcinoma in patients undergoing cystoprostatectomy for bladder cancer.
    • To determine if routine prophylactic urethrectomy is necessary.

    Main Methods:

    • 75 cystoprostatectomies for bladder cancer were performed between June 1976 and July 1985.
    • 72 patients were followed with 6-month urethral wash cytology studies.
    • Urethrectomy was performed upon positive cytology results.

    Main Results:

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    • 7 out of 72 patients (10%) had positive urethral wash cytology during follow-up and underwent urethrectomy.
    • Histological examination confirmed carcinoma in situ in all 7 urethrectomy specimens.
    • 6 of these 7 patients remain disease-free; one died without evidence of cancer.

    Conclusions:

    • Urethral wash cytology is a reliable method for detecting urethral carcinoma in this patient group.
    • Selective urethrectomy based on positive cytology avoids unnecessary procedures for the majority of patients.
    • This approach maintains a low rate of local recurrence and false positives.