Carcinoma in situ of the urethra associated with bladder carcinoma: the role of urethrectomy.

Carcinoma in situ of the urethral margin was demonstrated in 12 men who underwent radical cystectomy for bladder cancer. Six of the 7 patients who underwent simultaneous urethrectomy are free of the tumor but 4 of the 5 who did not undergo urethrectomy died of the disease. This dismal survival rate for patients with carcinoma in situ in the retained urethra indicates the necessity for clear-cut guide lines for the performance of urethrectomy. Frozen section of the urethral margin, as well as of both distal ureters, should be obtained at the time of operation, and urethrectomy, either simultaneous or during the same hospitalization, should be considered strongly for those with carcinoma in situ of the bladder neck or of the urethra.