Penile‐preserving surgery for male distal urethral carcinoma followed by buccal mucosa urethroplasty

Abstract

Abbreviations & Acronyms BMG = buccal mucosa graft MRI = magnetic resonance imaging PET-CT = positron emission tomography-computed tomography PUC = primary urethral carcinoma QOL = quality of life SCC = squamous cell carcinoma Introduction: We report a case of distal urethral carcinoma treated with segmental urethral excision and reconstruction by staged buccal mucosa urethroplasty. Case presentation: A 60-year-old man presented with difficulty urinating and a palpable mass on the ventral side of his penis. He was diagnosed as having localized distal urethral carcinoma (cT2N0M0) and underwent penile-preserving surgery with staged urethroplasty using buccal mucosa as substitute tissue. The pathological diagnosis was squamous cell carcinoma of the urethra (T2) with negative surgical margin. At 2 years of follow-up, there was no recurrence or metastasis, he could void in a standing position with an acceptable urinary stream, and he found the appearance of his external genitalia acceptable. Conclusion: In cases of distal primary urethral carcinoma, urethroplasty using buccal mucosa graft could be alternative treatment option providing a better postoperative quality of life.

Triangular extension of hinge flaps: A novel technique to resolve stomal stenosis and prevent restenosis in staged buccal mucosal urethroplasty

“…Although advances in reconstructive urology have enabled most cases of anterior urethral strictures to be reconstructed in a single stage, staged urethroplasty is still required in patients with complicated stricture and in those who have undergone multiple urethroplasties 1–9 . Staged substitution urethroplasty involves augmentation or replacement of the strictured urethral segment with a substitute, such as oral mucosa or a skin graft, in combination with the creation of a proximal urethrostomy for diverting urine.…”

A Primary Urothelial Carcinoma Presenting as a Mid-Bulbar Urethral Stricture in a 30-Year-Old Male

“…Extensive radical surgical removal of the tumor is currently regarded as the mainstay of management. However, small tumors of the urethra have been proven to be able to be treated with transurethral resection and penile preserving surgery [19][20][21]. A level one evidence could not be established to support the efficacy of chemotherapy and radiotherapy in the management of UC of the urethra due to the rarity of such conditions.…”