Urethral cancer in men
- Ralph Madeb, MD
Ralph Madeb, MD
- Assistant Professor of Urology
- Department of Urology
- University of Rochester School of Medicine and Dentistry
- Dragan Golijanin, MD
Dragan Golijanin, MD
- Director Section GU Oncology
- Urology Division, Brown University
- Edward Messing, MD, FACS
Edward Messing, MD, FACS
- Professor of Urology and Oncology
- University of Rochester School of Medicine and Dentistry
- Bridget F Koontz, MD
Bridget F Koontz, MD
- Assistant Professor of Radiation Oncology
- Duke University School of Medicine
- Section Editors
- Jerome P Richie, MD, FACS
Jerome P Richie, MD, FACS
- Section Editor — Cancer of the Urethra, Penis, and Ureter
- Section Editor — Urologic Surgery
- Section Editor — Prostate Cancer
- Elliott Carr Cutler Professor of Surgery
- Harvard Medical School
- W Robert Lee, MD, MS, MEd
W Robert Lee, MD, MS, MEd
- Section Editor — Prostate Cancer
- Professor of Radiation Oncology
- Duke University Medical Center
Primary urethral cancer is a rare malignancy in men . Differences in anatomy and etiology lead to important differences in the clinical presentation, diagnosis, and treatment of urethral cancer in men compared with women.
Information about the natural history and prognosis of urethral cancer in men is derived from small cases series, and recommendations for treatment are based upon general oncologic principles and extrapolation from other diseases.
The diagnosis, evaluation, and treatment of male urethral cancer will be reviewed here. Female urethral cancer is discussed separately. (See "Urethral cancer in women".)
The male urethra extends from the base of the bladder to the external urethral meatus and averages 21 cm in length. It is customarily divided into prostatic, bulbomembranous, and penile segments , or alternatively, into posterior (membranous and prostatic) and anterior (glanular, penile and bulbous) portions .
The normal prostatic and bulbomembranous urethral segments are lined with transitional epithelium that is similar to the upper urinary tract. The penile urethra is lined with pseudostratified columnar epithelium, and the meatus is lined with stratified squamous epithelium.
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- EPIDEMIOLOGY AND RISK FACTORS
- Risk factors
- - Chronic inflammation
- - HPV infection
- - Other factors
- CLINICAL PRESENTATION
- EVALUATION OF SUSPECTED DISEASE
- Staging system
- Early stage lesions
- - Local treatment approaches
- - Penectomy
- Partial penectomy
- Radical penectomy
- Approach to the scrotum
- - Non-surgical management
- Locally advanced lesions
- - Multimodality therapy
- Neoadjuvant therapy
- Surgical management
- - Role of lymphadenectomy
- Adjuvant therapy
- Definitive chemoradiation
- POSTTREATMENT SURVEILLANCE
- TREATMENT OF RECURRENT OR METASTATIC DISEASE
- SUMMARY AND RECOMMENDATIONS