For tumors that do not exceed 2 centimeters in greatest dimension, irradiation alone, nonexenterative surgery alone, or the combination may be sufficient to provide an excellent outcome. Pelvic lymphadenectomy is also recommended in view of the significant incidence of positive nodes, the limited added morbidity from such dissection, and the potential, although limited, possibility for cure. Despite extensive surgery, local recurrence does occur frequently and this event is invariably associated with eventual death from disease. In an effort to shrink tumor margins, the use of preoperative adjunctive radiation therapy must be considered. In an effort to increase the surgical margins of dissection, resection of the inferior pubic rami and the lower portion of the pubic symphysis has been used.
Urinary diversion is required.
Preoperative radiation followed by cystoprostatectomy, urinary diversion, and penectomy with bilateral pelvic node dissection with or without inguinal node dissection. Bracken RB, Johnson DE, Miller LS, et al. Primary carcinoma of the female urethra. Management of carcinoma of the female urethra. Diagnosis and Management of Genitourinary Cancer.