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Urethra and Penis
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
A periurethral abscess in relation to the bulbar urethra is even more uncommon. It may be associated with a urethral stricture, urethral trauma or, rarely, a urethral cancer. The infecting organisms are varied and can include both streptococci and anaerobic organisms. Extravasation of urine is not unusual. There is perineal pain with pyrexia, rigors and tachycardia. Tenderness and swelling rapidly spread from the perineum to the penis and the anterior abdominal wall. Ultrasound scanning and MRI are useful diagnostic aids and treatment with antibiotics are essential. Collections of pus should be drained and the urethra should be defunctioned by a suprapubic urinary catheter.
Urethral Cancer
Published in Dongyou Liu, Tumors and Cancers, 2017
Differential diagnoses for urethral cancer include (1) urothelial carcinoma of the urinary bladder with extension into the urethra, which tends to be more common than primary urothelial carcinoma of the urethra; (2) extension into the urethra of SCC of the penis, vulva, and cervix; (3) extension into the urethra of adenocarcinoma of nearby organs, including the prostate gland and the colon; and (4) nephrogenic adenoma of the urethra (mimicking clear cell adenocarcinoma).
Swedish National Guidelines on Urothelial Carcinoma: 2021 update on non-muscle invasive bladder cancer and upper tract urothelial carcinoma
Published in Scandinavian Journal of Urology, 2022
Fredrik Liedberg, Sofia Kjellström, Anna-Karin Lind, Amir Sherif, Karin Söderkvist, Karin Falkman, Helena Thulin, Firas Aljabery, Dimitrious Papantonio, Viveka Ströck, Elisabeth Öfverholm, Tomas Jerlström, Johan Sandzen, Ingrida Verbiene, Anders Ullén
The first Swedish national guidelines on urothelial carcinoma were published in 2013. Until then, regional treatment recommendations had been compiled separately in the majority of the six health care regions in Sweden. The European Association of Urology has also provided guidelines for the diagnosis and treatment of bladder cancer with the first guidelines published in 2000, and subsequently guidelines were also developed for both upper tract urothelial carcinoma and urethral cancer. Despite being a disease with limited funding for research [1], research priorities have been stated [2] and in the past few years our understanding of bladder cancer has increased with the description of molecular subtypes [3]. In addition, the approval of checkpoint-inhibitors in the setting of advanced bladder cancer in Sweden in 2017 has led to a new standard in the management of urothelial carcinoma. Thus, the evidence-base for diagnosing and treating urothelial carcinoma is growing and necessitates frequently updated clinical guidelines for clinicians. The process in the national guidelines group also considering adjustments from EAU-guidelines and bringing national experts together is also facilitating uniform implementation of new procedures and therapies.
Progress towards a Nordic standard for the investigation of hematuria: 2019
Published in Scandinavian Journal of Urology, 2019
Per-Uno Malmström, Erik Skaaheim Haug, Peter J. Boström, Sigidur Gudjónsson, Jørgen Bjerggaard Jensen
In the period 2013–2015, the number of F.T.P. investigations because of hematuria was approximately 13,000 per year, with 17.5% of patients found to have invasive urinary tract cancer. This includes renal cancer, invasive upper tract urothelial tumours, urethral cancer and invasive bladder cancer, whereas patients with findings of non-invasive Ta-tumour were not included in this percentage. Following the increase in the age limit for investigating symptomatic MiH from 40–60 years of age, the total number of hematuria referrals to the F.T.P. was only slightly reduced to ∼ 12,000 per year in the following years, 2016 and 2017. The number of positive findings increased slightly in the same period, leading to positive findings in 21.8%. Still almost half of the registred new cancers are diagnosed outside of the F.T.P.
Avelumab for the treatment of urothelial cancer
Published in Expert Review of Anticancer Therapy, 2018
Alejo Rodriguez-Vida, Joaquim Bellmunt
The role of avelumab in patients with UC was analyzed in an expansion-cohort phase Ib study within the JAVELIN Solid Tumor trial [16]. Eligible patients had histologically confirmed metastatic or locally advanced UC of the renal pelvis, ureter, urinary bladder, or urethra and disease progression after at least one prior line of chemotherapy. Archival or fresh tumor tissue samples were required for analyzing the immunohistochemical PD-L1 status on both tumor cells and tumor-associated immune cells, but patients were not pre-selected on the basis of the PD-L1 status because both PD-L1 negative and positive patients were eligible. In total, 44 patients were included. The median age of patients was 68.0 years; 68.2% of patients were male; 84.1% had a bladder or urethral cancer and 75% had visceral metastases. Approximately 31.8% of patients received three prior lines of chemotherapy, and 22.7% had been treated with three or more prior therapies. Among 37 patients evaluable for PD-L1 expression, 29.5% were considered PD-L1-positive tumors using a ≥ 5% staining threshold in tumor cells and 4.5% using a ≥ 10% threshold in tumor-associated immune cells.