Surgery is the most common treatment for urethral cancer. Small, superficial tumors may be removed completely using one of many techniques, including:
Laser resection (removal or destruction of the tumor using a laser)
Transurethral resection (removal of the tumor with surgical instruments passed into the urethra)
Fulguration (use of electrocautery to burn the cancerous tumor away)
Mohs surgery (removal of tissue in very thin layers in order to spare normal tissue)
Tumors that are large or invade into other structures or tissues require more extensive surgery. In men, a portion of, or the entire penis, may be removed (a partial or total penectomy). The bladder, prostate, and lymph nodes may also be removed. In women, the urethra, bladder, vagina, and lymph nodes in the area may be removed. Plastic surgery may be needed to rebuild the penis or vagina.
After surgery you may experience pain in the area near where the incision (cut) was made. This is normal and should not last for long. Bleeding and infection are other possible complications. Scarring of the urethra after surgery may cause difficulty urinating. If this happens, a procedure can be done (known as a urethral dilation) to help reopen the urethra. Your surgeon will discuss these risks in detail before the surgery.
If your bladder or your urethra is removed, your surgeon will make or build a urostomy, which is a small opening in the abdomen that gives you a new way of eliminating urine. You will then either need to wear a small pouch under your clothes to collect the urine or use a catheter to remove the urine from the urostomy site. Having a urostomy can have an impact on your comfort and your sexuality. Ask your surgeon what to expect in your case and for advice in dealing with it. An enterostomal therapist will work with you on how to take care of it.