ascending urethrography
voiding cystourethrography
MRI
IVU
C. MRI
well-differentiated tumor with broad-based invasive font
marked atypia distributed on wide areas of superficial urothelium
atypia is present
no atypia but marked degenerative epithelial changes
only in females
associated with chronic irritation, polypoid cystitis, and cystitis glandularis
no risk for squamous cell carcinoma
treated with estrogen, if symptomatic
2 - 4%
4 - 6%
6 - 8%
8 - 10%
frequently found in association with high-grade or extensive TCC
has a rate of progression to muscle invasion of 10-25%
significant areas of CIS are easily missed by routine cystoscopy
treatment begins with TURBT
often of high-grade sarcomas
often associated with muscularis propria invasion
due to vesical polyps occluding ureteric orifices
should be resected but not diathermized
the lesion is solitary and no associated CIS
physically, a surgical margin of 2-cm can be obtained
the resected area should be far enough from ureteral orifices and the bladder neck
all of the following
tumor stage
tumor grade
lymphovascular invasion
lymph node spread
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
working with organic chemicals and dyes
abuse of pain-control medications especially phenacetin
exposure to arsenic and aromatic amines
schistosomiasis
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
obstructive LUTS are common presentations and occur in association with carcinoma in situ
might present as perineal abscesses and fistulae
could be asymptomatic
venereal diseases increase the risk of urethral cancers
30%
40%
50%
60%
immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
comparable
upper ureter
middle ureter
lower ureter
comparable
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
obesity
consuming artificial sweeteners
asbestosis
analgesic abuse
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
leiomyoma
hemangioma
fibroepithelial polyp
lymphangioma
increase the irrigation fluid and pursue the procedure
abort the procedure and leave a urethral catheter
perform cystogram and manage accordingly
perform abdominal exploration and manage accordingly
infiltrative proximal penile urethral carcinomas
infiltrative distal penile urethral carcinomas
recurrent proximal penile urethral carcinoma after laser resection
T3/N2/M0 at bulbar urethra
patients with carcinoma in situ
patients with completely resected solitary tumor
patients with preserved kidney and liver functions after 2 courses of BCG
patients with leiomyosarcoma
ascending urethrography
voiding cystourethrography
MRI
IVU
irritative bladder symptoms
obstructive bladder symptoms
palpable suprapubic mass on physical examination
painless profuse hematuria
40 - 55%
55 - 70%
70 - 85%
85 - 100%
continue the procedure as perforations at this site do no harm
abort the procedure and leave a urethral catheter
convert tumor removal to open method and repair the defect
perform abdominal exploration and manage accordingly
transitional cell carcinoma
squamous cell carcinoma
adenocarcinoma
small cell carcinoma
urine cytology
CT urography
cystoscopy
renal function tests
0.6 - 2%
2 - 6%
6 - 10%
12 - 16%