Immediate versus staged urethrectomy in patients at high risk of urethral recurrence: is there a benefit to either approach?

Urology
Philippe E SpiessH B Grossman

Abstract

To compare treatment-related outcomes of immediate and staged urethrectomy in patients at high risk of urethral recurrence. We retrospectively identified 76 male patients with cystectomy for transitional cell carcinoma of the bladder who had undergone urethrectomy in the absence of established urethral recurrence. Concomitant cystoprostatectomy and urethrectomy was performed in 57 patients and staged urethrectomy in 19 patients. The criteria for staged urethrectomy were the presence of a positive urethral margin or established transitional cell carcinoma of the urethra in the cystectomy specimen. The mean interval from cystectomy to staged urethrectomy was 4.7 months (range 1.4 to 14). The most common pathologic finding of the urethrectomy specimens was prostatic duct involvement (31.6%) in the immediate urethrectomy group and Stage pT0 in the delayed urethrectomy group (73.7%). No statistically significant difference in disease-specific survival was noted between the immediate and staged groups (P = 0.14). Similarly, no difference was noted in postoperative complication rates or total operative blood loss (P = 0.77 and P = 0.64, respectively). However, a slight benefit for immediate urethrectomy was noted in the total duration...Continue Reading

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Citations

Aug 3, 2010·The Urologic Clinics of North America·Shawn E White, S Bruce Malkowicz
Sep 20, 2008·The Journal of Urology·Jason L NellesUNKNOWN Urologic Diseases in America Project
Dec 17, 2008·BJU International·Hein Van PoppelLuitzen-Albert Groen
Mar 30, 2010·BJU International·Paolo PuppoUNKNOWN AURO.it guideline committee
Sep 8, 2020·Japanese Journal of Clinical Oncology·Kyohei HakozakiMototsugu Oya

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