A prospective multicentric international study on the surgical outcomes and patients' satisfaction rates of the "Sliding Technique" for end-stage Peyronie's disease with severe shortening of the penis and erectile dysfunction

OBJECTIVE - Urethral recurrence (UR) after radical cystectomy is rare but associated with high mortality. With the recently increased use of orthotopic bladder substitution and the questionable benefit of prophylactic urethrectomy, identification of patients at high risk of recurrence, management of the remnant urethra, and treatment of recurrence become critical questions.

To summarize the current literature on the diagnosis and management of urethral recurrence after radical cystectomy.

PATIENT AND METHODS - A review of the PubMed database from 1980 to 2014 was performed to identify studies evaluating recurrent urothelial cancer of the urethra after radical cystectomy. The search terms used included urethral recurrence, cystectomy or cystoprostatectomy. Selected studies provided information on the type of urinary diversion performed, the incidence of recurrence, and the time to recurrence.

RESULTS - Incidence of UR after radical cystectomy ranges from 1-8% with most recurrences occurring within the first two years after surgery. Increased risk of UR is associated with involvement of the prostate, tumor multifocality, bladder neck involvement, and cutaneous diversion. Median overall survival after urethral recurrence ranges from 6-54 months and 5-year disease specific survival after UR is reported between 0-83%.

CONCLUSIONS - Urethral recurrence remains a relatively rare event. Current literature suggests that urethral wash cytology may be useful in patients with intermediate to high risk recurrence to enable early detection of non-invasive disease, which may be amenable to conservative therapy prior to urethrectomy. This article is protected by copyright. All rights reserved.

BJU international. 2015 Nov 11 [Epub ahead of print]

L Rolle, M Falcone, C Ceruti, M Timpano, O Sedigh, D J Ralph, G Garaffa, F Kuehhas, M Oderda, M Preto, M Sibona, A Gillo, P Gontero, B Frea

Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , St. Peter's Andrology and The Institute of Urology, University College of London Hospital (UCLH), London, UK. , St. Peter's Andrology and The Institute of Urology, University College of London Hospital (UCLH), London, UK. , Department of Urology, Medical University of Vienna, Austria. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy. , Department of Urology, University of Turin, Città della Salute e dellaScienza, Turin, Italy.

PubMed

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