Freeman J A, Esrig D, Stein J P, Skinner D G
Division of Urology, University of North Carolina, School of Medicine, Chapel Hill.
Urol Clin North Am. 1994 Nov;21(4):645-51.
Urethral recurrence develops in roughly 10% of patients following cystectomy for bladder cancer and appears to be another manifestation of the multicentric nature of TCC. By far the greatest risk factor for recurrence is tumor involvement of the prostate in the radical cystectomy specimen, with prostatic stromal invasion more ominous than either ductal or mucosal involvement. For patients in whom orthotopic diversion is contemplated, precystectomy screening of the prostate is recommended by means of deep transurethral biopsy. Surveillance of the urethra following cystectomy should be done by urethral wash cytology at 6-month to yearly intervals and must be continued for life. Management of documented urethral recurrence should be by total urethrectomy, including the meatus.
膀胱癌膀胱切除术后约10%的患者会发生尿道复发，这似乎是移行细胞癌多中心性质的另一种表现。到目前为止，复发的最大危险因素是根治性膀胱切除标本中前列腺受肿瘤侵犯，前列腺基质浸润比导管或黏膜受累更凶险。对于考虑原位改道的患者，建议在膀胱切除术前通过深部经尿道活检对前列腺进行筛查。膀胱切除术后应通过尿道冲洗细胞学检查对尿道进行监测，间隔6个月至1年，且必须终身持续。确诊尿道复发的治疗应行全尿道切除术，包括尿道口。
