Female urethra is ∼4 cm long. Muscular layer is continuous with that of the bladder. Two sphincters: internal at bladder neck and voluntary sphincter at plane of urogenital diaphragm. Proximal 1/3 epithelium = transitional cells. Distal 2/3 epithelium = nonkeratinizing squamous cells. Periurethral Skene’s glands secrete mucous near meatus (and extend along distal urethra). Carcinoma of urethra is rare (<0.1% of cancers). 70% = squamous cell CA 10–15% = TCC 10–15% = adenoCA Rare = melanoma, lymphomas, mets, adenoid cystic Average age is 60 (50–80) years. May be associated with HPV 16. Female urethra cancer more common than male urethral cancer (4:1). Male urethral CA. Urethral location: bulbomembranous 60%, penile 30%, prostatic 10% Histology: 75% squamous cell CA LN spread is to inguinal and pelvic LN (including presacral and obturator). T1 lesions = uncommon. T2–T3 lesions = 35–50% of cases. For urethra, clinically involved LN are almost always pathologically involved (vs. penile carcinoma only ∼50% are pathologically involved). At presentation, ∼10% of patients have DM. Most important prognostic factors = tumor size, local invasion, and location (distal more favorable).
KeywordsBladder Neck Urethral Stricture Urethral Orifice Distal Urethra Female Urethra
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