En bloc transpubic urethrectomy in conjunction with radical cystectomy for bladder carcinoma in males

A technique for en bloc transpubic urethrectomy and radical cystectomy in the male is described and compared with commonly employed means of urethrectomy. Although this technique has been performed in a limited number of cases, this report is warranted because of the following advantages: en bloc resection is achieved at one operation without compromised positioning or need to reposition; the risk of transecting tumor in the urethra or leaving tumor behind in the urethra is avoided; the contamination inherent with a perineal incision and the resulting increase in morbidity are avoided, yet the mobilization of the urethra and prostate is comparable to that achieved transperineally; the exposure with this technique equals or excels that achieved by other approaches; although thirty minutes are required to perform pubectomy and urethrectomy, this is comparable to the time required to expose and close the perineum; and usually time is saved because of the improved exposure.