The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder

Kang Su Cho, Joo Wan Seo, Sung Jin Park, Young Hoon Lee, Young Deuk Choi, Nam Hoon Cho, Seung Choul Yang, Sung Joon Hong

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38 Citations (Scopus)


Purpose: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma. Patients and Methods: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis. Results: Urethral recurrence developed in 13 patients (4.4%) and the 5-year urethral recurrence-free probability was 94.9%. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence. Conclusion: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.

Original languageEnglish
Pages (from-to)306-311
Number of pages6
JournalUrologia Internationalis
Issue number3
Publication statusPublished - 2009 May

Bibliographical note

Funding Information:
The authors wish to acknowledge funding for field work from various Australian Research Committee grants and the University of Coruña. They also thank Dr J.A. Bourne for valuable discussions in the field and for constructive comments on the manuscript in draft, and Emeritus Professor H. Wopfner and two unnamed reviewers for constructive and critical comments.

All Science Journal Classification (ASJC) codes

  • Urology


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