Shinka T, Uekado Y, Aoshi H, Komura T, Ohkawa T
Department of Urology, Wakayama Medical College, Japan.
J Urol. 1989 Oct;142(4):983-7. doi: 10.1016/s0022-5347(17)38961-9.
Partial urethrectomy (at least to the bulbous portion) was performed simultaneously in 128 consecutive male patients undergoing radical cystectomy for bladder cancer. Transitional cell carcinoma developed subsequently in the distal urethral remnant in 5 patients (4.0%) followed for 2.6 to 5.7 years (mean 4.1 years) postoperatively. These 5 patients originally had nonpapillary, multifocal and histologically high grade (5) and low stage (4) bladder cancer, 4 with associated carcinoma in situ. Our results suggest that simultaneous total urethrectomy should be considered strongly for patients with high grade nonpapillary multifocal bladder cancer associated with carcinoma in situ. Furthermore, the pattern of distal urethral recurrence in our patients may provide information regarding the appropriate management of the male urethra in potential candidates for continent urinary diversion.
在128例因膀胱癌接受根治性膀胱切除术的男性患者中，同期进行了部分尿道切除术（至少至球部）。术后随访2.6至5.7年（平均4.1年），5例（4.0%）患者的尿道远端残余部分随后发生了移行细胞癌。这5例患者最初患有非乳头状、多灶性且组织学分级为高级别（5例）和低分期（4例）的膀胱癌，4例伴有原位癌。我们的结果表明，对于伴有原位癌的高级别非乳头状多灶性膀胱癌患者，应强烈考虑同期进行全尿道切除术。此外，我们患者的尿道远端复发模式可能为潜在可控性尿流改道患者的男性尿道合理管理提供信息。
