Surgery is the most common treatment for cancer of the urethra. There are many different methods that can be used, depending on whether the cancer is superficial or invasive.
If the tumor has not grown into nearby tissues, it may be removed with a tool such as a cystoscope. The tool is moved into the urethra, and an electrical loop can be used to remove the tumor.
Some patients may need surgery to remove the growth. Most of the time, urethral cancers in the anterior urethra (the part closest to the outside) are treated well with local surgery. Tumors that involve the posterior urethra (the part closest to the bladder) often need more radical surgery to get the best result.
Anterior Urethra in Men
Men with a tumor that involves only this part of the urethra (inside the penis) may need part or the whole penis removed. This depends on where the tumor is and how it can be removed. The goal is to leave enough tissue to allow a man to stand while urinating. If the tumor is growing into the erectile tissues of the penis, the whole penis may need to be removed. In this case, a small hole is made on the underside of the scrotum to allow voiding. This means the patient will sit to urinate.
Posterior Urethra in Men
If the tumor is in this area, the bladder and prostate, part of the bony pelvis, and the penis are at risk. If surgery is needed to remove these organs, a piece of bowel is used to make a pouch. The kidneys can then drain into the pouch.
This pouch can either be incontinent (you will need to wear a stoma bag) or continent (you will need to drain the pouch several times a day with a small catheter). Deciding which type depends on other health issues you have and your preference. For more information on Urinary Diversion please visit our Conditions Page.
Posterior Urethra in Women
With this type of tumor, surgery is needed. Because the female urethra is so short, it is rare to have a tumor small enough and far enough away from the urethral sphincter (the muscle that controls the release of urine) to remove it and still be able urinate normally.
The outermost third (or about 7 mm) of the urethra can be removed without too much trouble. Unfortunately, most women with urethral cancer need more involved surgery. The urethra, bladder and a part of the vagina are often removed. A pouch can be made with bowel for the kidneys to drain into. This pouch would then be used to remove urine from the body.
Lymph Node Removal
The lymph nodes in the pelvis are often removed in both men and women undergoing these surgeries. Some people may have leg swelling. This happens because these nodes usually drain the fluid that seeps out of the blood vessels into the legs. Once these nodes are removed, fluid can build up. If this becomes bothersome, consult your health care provider.