Primary Female Urethral Carcinoma
摘要
Between July 1981 and May 1996, we had encountered ten cases of primary female urethral carcinoma on an average age of 66 years. The predominant symptoms were urethral bloody spotting or hematuria(80%) and voiding difficulty (50%). All but one lesions were located at the anterior urethra that could be easily detected during pelvic easmination. Histologically there were 3 epidermoid/squamous cell carcinomas, 3 transitional cell carcinomas, 3 adenocarcino-mas, and 1 undifferentiated carcinoma. Two patients dropped out after biopsy. The other eight patients received complete stagning according to the modified Grabstald’s classification. Five stage A and three stage D1 urethral cancers were noted. Surgical intervention, including local excision. urethrectomy and regional lymph nodes dissection, was the mainstay of treatment. Ad-juvant radiotherapy was administrated in five patients. Of the five stage A cancers, one patient died of metastases four years later. The other four patients were disease-free for 38 to 189 months. Of the three stage D1 cancers, one patient died of metastases within one year. Another one, the only posterior urethral carcinoma, suffered from local recurrence ten months later. The other one was disease-free for 24 months. The average follow-up period for survival patients was 88 months. The result reveals that the anterior urethral cancers tend to be of a lower stage at di-agnosis. The prognosis for urethral cancers is related to the stage at diagnosis instead of cell type, regardless of treatment modalities. In conclusion, the diagnosis of female urethral carci-noma should be considered in women who have bladder outlet obstruction or who complain of urethral bleeding. Careful history taking, pelvic examination and biopsy can provide early diag-nosis and treatment to improver the survival rate. (J Urol R.O.C., 8:197-201,1997)