Clinical Investigation of the Female Urethral Cancer

Kim, Kwang Myoung; Lee, Hee Yong

Abstract

Primary cancer of the female urethra is a relatively rare disease. During the past 10 years, we could collect 11 cases of the female urethral cancer which were confirmed by pathological examinations. The results of clinical investigation were as followed: 1. The age distribution was from 28 years old to 72 years old and the average was 57 years old. The most common age group was 50 to 69 years (73%). 2. The intervals from onset of symptoms to admission were distributed as follows: the most common group was within 1 year (64%), the second common group was within 3 year (27%) and the third was within 3 months (9%). 3. The common symptoms were as follows: urinary frequency in 9 cases (82%), dysuria in 7 cases (64%), urethral mass in 6 cases (55%), urinary retention in 5 cases (46%), urethral bleeding in 4 cases (36%), hematuria in 2 cases (18%) and urethral pain in 2 cases (18%). 4. Histopathological findings showed squamous cell carcinoma in 5 cases (45%), adenocarcinoma in 4 cases (36%) and transitional cell carcinoma in 2 cases (18%) in order of their frequency. All of the 5 cases of squamous cell carcinoma were vulvourethral types. Among the 4 cases of adenocarcinoma, 3 cases were urethral types and 1 case was vulvourethral type. The 2 cases of transitional cell carcinomas were urethral type and vulvourethral type. 5. Clinical stages were distributed as follows: 2 cases were stage A, 3 cases. stage B, 2 cases, stage C and 4 cases, stage D. In the 7 cases of vulvourethral type, 5 cases were stage A or stage B and 2 cases were stage C or stage D, but the 4 cases of urethral type were stage C or stage D. 6. Treatment of female urethral cancers consisted of surgery and irradiation in general. 1) Local excision was performed on the 2 cases of stage A, but tumor recurrence occurred in 1 case after 1 month postoperatively. 2) In stage B, local excision and interstitial irradiation were made on 1 case, external and interstitial irradiation on 1 case and external irradiation only on 1 case. In the 1st case, tumor recurred after 1 month postoperatively and urinary retention developed after 6 months postoperatively. so suprapubic cystostomy was performed. In the second case, we couldn`t follow up, and in the last case the treatment showed no beneficial effect. 3) In stage C, anterior pelvic exenteration and Bricker`s operation were made on 1 cases. And only suprapubic cystostomy was performed on 1 case but the patient died after 14 months postoperatively. 4) It stage D, suprapubic cystostomy was performed on 3 cases. Among which 1 case died after 6 months postoperatively and 2 cases couldn`t be followed up. The other 1 case was operated with cystourethrectomy and Bricker`s operation but the metastasis to retroperitoneal lymph nodes was found in operative field. This case also couldn`t be followed up.