Management of the urethra in patients undergoing radical cystectomy for bladder carcinoma

Computerized data on 174 male patients who underwent radical cystectomy for bladder carcinoma were studied in relationship to the incidence of urethral involvement. Simultaneous or delayed urethrectomies were done on 32 patients, 7 of whom had overt urethral carcinoma (4 per cent of the total number of male patients) and 10 of whom had carcinoma in situ (5.7 per cent of the total number of male patients). The low incidence of these 2 phenomena leads us to the conclusion that routine urethrectomy need not be done on patients undergoing radical cystectomy unless overt urethral carcinoma or positive margins are found at cystectomy. We believe that the use of urethral cytologies is crucial to the routine followup of patients who have undergone radical cystectomy for bladder cancer and should be combined with clinical followup to establish the indication for urethrectomy.