Carcinoma Of The Urethra

Carcinomas of the urethra are rare and occur in both sexes; it may squamous or urothelial carcinomas or adenocarcinomas rarely.

Most patients are in the age of ? 50. Certain types of human papillomavirus have been associated with certain cases. Urethral tumors spread early in the surrounding structures, and therefore tend to be well advanced at diagnosis. The lymph nodes of the external inguinal region or basin (obturator) are usually the first metastasis stations.

Carcinomas of the urethra are rare and occur in both sexes; it may squamous or urothelial carcinomas or adenocarcinomas rarely. Most patients are in the age of ? 50. Certain types of human papillomavirus have been associated with certain cases. Urethral tumors spread early in the surrounding structures, and therefore tend to be well advanced at diagnosis. The lymph nodes of the external inguinal region or basin (obturator) are usually the first metastasis stations. Symptoms and signs Most women present with hematuria and symptoms of voiding dysfunction or urinary retention. Most complain of urinary frequency or urethral symptoms (hypersensitivity of the pelvic floor muscles). Most men present with symptoms of urethral stricture; few have hematuria or bloody discharge. In advanced tumor sometimes a mass can be palpated. Diagnosis Diagnosis is suspected clinically and confirmed by Zystourethroskopie. To distinguish them from Carcinoma of the Urethra, prolapse and Caruncle a biopsy is required. CT or MRI can be used for staging. Prognosis The prognosis depends on the precise localization in the urethra and the extent of the tumor disease, especially of the invasion depth decreases. The 5-year survival rate for patients with distal tumors> 60% and for those with proximal tumors in 10-20%. The recurrence rate is> 50%. Therapy Usually excision or ablation for superficial or minimally invasive distal tumors of the anterior urethra the treatment consists of surgical excision, radiation therapy (interstitial or a combination of brachytherapy and external radiation therapy), fulguration, laser therapy or ablation. Larger and deeper invasive anterior tumors and proximal tumors of the posterior urethra require multimodality therapy with radical resection and urinary diversion, usually in combination with radiotherapy. The surgery involves a bilateral pelvic lymph node dissection and sometimes inguinal, pubic often with removal of parts of the symphysis and the inferior pubic ramus. The value of chemotherapy sometimes used has not yet been proven.

Health Life Media Team

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