Leiomyoma of the female urethra.

Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. There are only 14 documented cases of leiomyoma of the female urethra in the literature. A careful analysis of these cases revealed the average patient age to be 34.1 years. The site of the lesion determined the clinical features and the surgical approach. No common etiological factor could be ascertained. Two additional cases of leiomyoma of the female urethra are reported.     

Traumatic avulsion of the female urethra: case report

Complete rupture of the female urethra is rare. We found only 30 such cases described in the literature, 19 of which were in children. In most of these patients, the proximal urethra and bladder neck were injured. Herein we report on the complete rupture of the distal part of the urethra in a female child with a pelvic fracture. This diagnosis should be considered in such cases with deep vaginal lacerations, inability to void, and with unsuccessful catheterization.     

Urethral diverticula surrounding the urethra in women: report of 2 cases

We report two cases of female urethral diverticula. A 49-year-old woman (case 1) complained of perineal pain when she voided urine. A 36-year-old woman (case 2) complained of perineal pain. In both cases, intravenous pyerography and urethrography revealed diverticula around their urethra, and we diagnosed them with urethral diverticula which surrounded their urethra by magnetic resonance imaging. We treated them by transvaginal diverticulectomy. Case 2 was successfully treated, but the diverticulum recurred after one year in case 1. There are over 200 reported cases of female diverticula in the Japanese literature, but a urethral diverticulum surrounding the urethra is rare.     

Primary adenocarcinoma of the female urethra: report of two cases

Two cases of primary adenocarcinoma of the female urethra are reported. Case 1 was a 75-year-old female presenting with the complaint of genital bleeding. Physical examination revealed a pea-sized tumor in the urethral meatus. Tumor resection was performed under the preoperative diagnosis of caruncles, but, histopathological examination revealed adenocarcinoma. She was readmitted because of recurrence of tumor 7 months after the first operation. En bloc resection including the bladder, urethra and uterus was done followed by ileal conduit for urinary diversion. Case 2 was an 85-year-old female presenting with the complaint of macroscopic hematuria. Physical examination revealed a thumb's-head-sized tumor in the urethral meatus and also the left enlarged inguinal lymph nodes. Tumor resection and biopsy of the left inguinal lymph nodes were performed. Histopathological examination revealed adenocarcinoma. Postoperative irradiation to the left inguinal lymph nodes was given to a total dose of 4,000 rads. Ninety-two cases of primary adenocarcinoma of the female urethra in the Japanese literature including our cases are reviewed.     

Non-Hodgkin lymphoma of the female urethra.

The third case of a malignant non-Hodgkin lymphoma of the female urethra is reported. The urethra was the primary localisation of the malignancy. In the two other cases which could be found in a literature review urethral involvement by this disease was secondary to other organs. In all cases the tumor first was described as a caruncle. Non-Hodgkin lymphoma should be considered in the differential diagnosis of urethral tumors.     

Non-Hodgkin's lymphoma of the female urethra presenting as a caruncle

Primary non-Hodgkin's lymphoma of the female urethra is extremely rare. To our knowledge only 10 cases have been reported to date. We present the 11th case in the literature.     

Carcinoma in diverticulum of female urethra

A case of carcinoma originating in a diverticulum of the urethra in a female patient is presented. A review of 143 cases of carcinoma of the female urethra treated from 1948 to 1984 at The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston disclosed 6 additional patients with diverticular carcinoma. Analysis of their clinical features, treatments--various combinations of primary excision, radiotherapy, and chemotherapy--and survival results indicate that survival is primarily a function of grade. Only 40 cases of carcinoma in urethral diverticula are recorded in the world literature. The majority are adenocarcinomas, and the most frequent presenting symptoms are dysuria, frequency, and urgency. Radiotherapy successfully established long-term control of the disease with low morbidity in all of our patients who had low-grade tumors.     

Fractured pelvis with avulsion of the female urethra

Injuries to the female urethra, except for meatal straddle injuries and those associated with instrumentation, are rarely seen with pelvic trauma. To our knowledge this is the first case of traumatic complete disruption of the female membranous urethra reported in the English literature.     

The antimicrobial defense mechanism of the female urethra: a reassessment

PURPOSE: This review of the literature and study of the cytology of the urethra were done to define the potential role of the female urethra as a staging site for urinary tract infection and examine the evidence for a urethral defense mechanism. MATERIALS AND METHODS: We re-analyzed data on the quantitative microbiology of the female urethra published 3 decades ago, reviewed the literature on the initiation of ascending urinary tract infections, the cytology and anatomy of the urethra, and performed studies of the morphology of urethral cells in boys and girls, men, menstruating and menopausal women, and women with acute cystitis. We also considered clues about the urethral microenvironment provided by gonococcal cervicitis and urethritis. RESULTS: We found strong statistical evidence that the female urethra has a powerful antimicrobial defense mechanism, which appears to differ in women with and without recurrent urinary tract infections. We corroborated the findings of previous investigators that the female urethra is lined by cells identical to those of the vagina that respond similarly to estrogens. We found immature basal and parabasal cells in children, and a modest inflammatory response to urinary tract infection. CONCLUSIONS: The female urethra may provide a favorable environment for colonization by uropathogens but it is protected by a powerful defense mechanism. This mechanism may be explained by the shedding of uropathogens bound to exfoliating urethral cells, trapping of bacteria by mucus secreted by the paraurethral glands, intermittent washout by urine, local production of Ig, cytokines and defensins and mobilization of leukocytes.     

A large primary malignant melanoma of the female urethra

We present a case of large, primary malignant melanoma of the female urethra with poor prognosis in this case report. Malignant melanoma is one of the rare tumors of the female urethra and accounts for 0.2% of all malignant melanoma cases. Large (5.6 cm in diameter), primary malignant melanoma of the female urethra is exceedingly rare.     

Transitional cell carcinoma of distal female urethra

A rare case of carcinoma of female urethra from transitional cell origin is reported. The occurrence of primary transitional cell carcinoma in the urethra is being discussed, with review of the literature.     

Urethral tuberculosis.

Tuberculous affection of the urethra is very rare. Herein we report 2 cases of urethral tuberculosis. One in a young married female who had isolated urethral involvement presenting as urethral caruncle and the second in a young male with urethral stricture complicated by fistulae and abscess in association with renal tuberculosis. The relevant literature is briefly reviewed.     

原发性女性尿道黑色素瘤(附4例报告)

目的　探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗方法。方法　对4例女性原发性恶性黑色素瘤进行临床病理分析及随访观察。结果　4例患者均为尿道外口肿物就诊。2例因术前诊断不清,仅作局部切除,其中 1 例术后 16 个月死于肿瘤复发,1例仍在随访中;另2例行全尿道切除,双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论　女性尿道原发性黑色素瘤恶性度高,临床易误诊,早期诊断的主要依据是病理学探查,及时规范手术是提高患者生存率的主要方法。     

Primary malignant melanoma of the female urethra: a case report

A 76-year-old woman visited us with the chief complaint of a urethral mass on September 11, 1984. There was a thumb-sized, brownish and painless mass in the posterior wall of the urethra. Although excretory urogram revealed nothing remarkable, CT scan suggested metastasis of retroperitoneal lymph nodes. Biopsy of the urethral mass revealed malignant melanoma. She was treated with combined chemotherapy of dimethyltriazenoimidazole carboxamide, peplomycin, and cis-diamine-dichloride platinum, but died of respiratory insufficiency on January 6, 1985. Thirteen cases of primary malignant melanoma of the female urethra, including our own, have been reported in the Japanese literature.     

A case of primary adenocarcinoma of the female urethra

A 53-year-old female visited our hospital with a complaint of acute urinary retention. Transvaginal ultrasonography, computed tomography and magnetic resonance imaging showed extreme thickening of the urethral wall. Histopathological examination of the transvaginal needle biopsy suggested well-differentiated adenocarcinoma. She underwent total cysto-urethrectomy with partial vaginal wall resection and ileal conduit urinary diversion. Pathological diagnosis of the tumor was columnar adenocarcinoma invading into the vaginal wall and periurethral connective tissue. Fifty-eight cases of primary adenocarcinoma of the female urethra in the Japanease literature are briefly reviewed.     

女性早期尿道癌膀胱黏膜尿道重建术的探讨(会议征文选登)

目的:探讨应用膀胱黏膜重建女性尿道治疗女性尿道肉阜早期癌变的疗效。方法:对10例女性尿道肉阜早期癌变患者行一期膀胱黏膜尿道重建术,并作术前、术后6个月及术后1年最大尿流率测定。结果:10例均一期成形,术后随访1-9年,排尿正常,无肿瘤复发,无尿失禁及其他并发症,术前、术后6个月及术后1年最大尿流率测定差异有统计学意义(P(0.05)。结论:对于女性尿道肉阜早期癌变及早期原发性女性尿道癌患者,应用膀胱黏膜尿道一期重建术是可行的治疗方法,具有简单、安全、有效、并发症少等优点。     

Vaginal and phallic urethra with prominent clitoris in female pseudohermaphroditism

Idiopathic female pseudohermaphroditism associated with a vaginal urethra, prominent clitoris and an accessory phallic urethra is a rare syndrome, with no apparent cause to account for the masculinization of the genitalia and exhibit of similar characteristic features. We report such a case and review the pertinent literature.     

Intermittent bladder urinary retention in a young woman. An unusual presentation of partial urethral duplication

A singular case of female accessory urethra associated to a mobile bladder stone with an unusual clinical presentation is reported. The role of perineal ultrasound is emphasized as a useful diagnostic tool to study female urethra in a static and dynamic setting, including cases of partial or complete urethral duplication.     

女性尿道原发性恶性黑色素瘤3例报告

目的：探讨女性尿道原发性恶性黑色素瘤的临床特征及治疗手段。方法：对3例女性原发性尿道恶性黑色素瘤进行临床病理分析及随访观察。结果：3例均以尿道外口包块就诊。2例因术前诊断不清，仅局部切除，其中1例术后半年死于肿瘤复发。1例正在随访中；1例行全尿道切除，双侧腹股沟淋巴结清扫及永久性膀胱造瘘。结论：女性尿道原发性恶性黑色素瘤恶性度高，临床易误诊，早期确诊的主要依据是病理学检查，及时规范手术是提高患者生存率的主要手段。     

Villous adenoma of female urethra

Villous adenoma of the female urethra is extremely rare. We present one such case and compare with only other case reported in the literature.