探讨原发性尿道癌的临床特点及最佳治疗方法

Clinical features and optimal treatment of primary urethral carcinoma

目的本研究旨在回顾女性尿道癌患者的病历资料,探讨其临床表现和治疗效果,以提高对该罕见恶性疾病的认识。方法回顾性分析2012年1月—2022年12月在北京大学人民医院泌尿外科就诊的8例女性尿道癌患者。患者接受尿动力学检查、膀胱尿道镜检查、病理活检等,最终明确诊断为尿道癌。其中5例接受传统尿道癌根治术,3例接受保留膀胱的下尿道癌根治术。结果8例女性尿道癌患者年龄范围为36~68岁,平均年龄为53.75岁。尿路梗阻和下尿路症状是常见症状,尿道口肿物也较为常见,尿动力学检查显示膀胱出口梗阻。手术治疗后,保留膀胱的下尿道癌根治术在出血量、手术时间和术后住院时间上均优于传统尿道癌根治术。结论女性原发性尿道癌罕见,是具有侵袭性的癌症,早期诊断和根治性手术是提高患者预后的关键。保留膀胱的下尿道癌根治术在治疗效果和术后患者生活质量方面优于传统尿道癌根治术。

Objective To explore the clinical features and treatment outcomes of female urethral carcinoma so as to improve the awareness and prognosis of this rare malignant disease.Methods Clinical data of 8 cases of female urethral carcinoma treated during Jan.2012 to Dec.2022 at the Department of Urology of Peking University People s Hospital were retrospectively analyzed.The patients underwent urodynamic tests,cystourethroscopy and pathological biopsy to confirm the diagnosis.Traditional radical surgery was performed in 5 cases,and radical surgery for lower urethral cancer with bladder preservation was performed in 3 cases.Results The patients aged 36 to 68 years,with a mean of 53.75 years.Urinary obstruction,lower urinary tract symptoms and urethral masses were common manifestations.Urodynamic tests indicated bladder outlet obstruction.After surgical treatment,radical surgery for lower urethral cancer with bladder preservation showed advantages over traditional radical surgery in terms of intraoperative bleeding,operation time and postoperative hospital stay.Conclusion Female primary urethral carcinoma is rare but invasive.Early diagnosis and radical surgery are crucial for improving the prognosis.Radical surgery for lower urethral cancer with bladder preservation has better treatment outcomes and postoperative quality of life compared to traditional radical surgery.For such patients,symptoms should be closely monitored and timely diagnosis and treatment should be performed.