Briiislr Jortrirnl of Urology (1976). 48, 346 @
Short Case Report
Leukoplakia of the Male Urethra Leukoplakia of the renal pelvis, ureter, bladder, glans penis and vulva has been well documented but very little has been written about leukoplakia of the urethra, except to mention that it does occur. 8 cases have been reported-3 by Kretschmer (1928), 1 each by Schloss (1956) and Per1 (1965) and 3 by Reece and Koontz (1975). The following case is probably the first to be reported from the United Kingdom and has several unusual features.
cystitis, especially on the posterior wall. A small biopsy was taken from one of the white rings in the urethra. Histology showed the junction between regular transitional epithelium and hyperplastic, regular squamous epithelium covered by a thick surface band of keratin (Fig.). The appearance confirmed the diagnosis of leukoplakia of the urethra.
Comment
Apart from cases of leukoplakia of the bladder extending into the posterior urethra. all the reported cases of leukoplakia of the urethra have involved the distal segment of the anterior urethra. The disease in t h i b segment has invariably produced at least meatal stenosis, usually a long narrow stricture and occasionally a urethral diverticulum. The case reported is, therefore, unusual in that there was no meatal stenosis, only the bulbar urethra was involved and only slight narrowing of the urethra had occurred. N o specific treatment is being given to this patient, as he has no symptoms now and his urine has never been infected. He will be followed up carefully in case it stricturc develops and because ofthe known association between leukoplakia of the urinary tract and squamous carcinoma (O'Flynn and M ullaney, 1974).
Case Report A 23-year-old white man was admitted with a history
of haematuria with the passage of clots, slightly increased frequency and pain on micturition for 1 day. He had passed some blood in his urine when he was 3 years old but this had ceased spontaneously. His father had had haeniaturia the same year but the cause for this was not known. The only abnorniality to be found o n general examination was some suprapubic tenderness. Urine: Miscoscopy: more than 50 million WBCs and RBCs per litre. Culture: no significant growth. No tubercle bacilli on microscopy or culture. Cytology: atypical cells. I V P : the upper urinary tract was normal. C,~.rtortrc,r/irl)scupy. There were circular rings around the bulbar urethra extending over about 3 cm. These rings were slightly constricting the lumen and appeared white with some rough, raised nodules. The cystoscopc (21 F) passed easily through them. In the bladder there were patchy areas of haemorrhagic
P. VIJAYAN,P. B. CLARK and C. K . ANDERSON Drprrrtnient o f llroloig~~,The Gencwl / t i f i r n r w ~ j ~ ,
Lerds
References KRETSCHMER, H. L. (1928). Leucoplakia of the urinary organs. Srirgfwy, @8~ieidog.vc i n d Oh.ctrtric.>,47, 14s- I 54. O'FLYNN,J. D. and MULLANEY, J . (1974). Vesical leukoplakia progressing to carcinoma. British Joiirtrul of UroluK.v, 46, 31 -37. PERL,J. I. (1964). Intraluminal bcta irradiation in leukoplakia constricting the male urethra. Jorirnnl Of ui'OkJ&r.V 91,, 76-78. RI'ECE,R. W. and KOONTZ, W. W. (1975). Leukoplakia of the urinary tract-a review. Jorirnrrl of U ~ U / O R 114, > , 165-171. SCHLOSS,W. A. (1956). Leukoplakia of the male urethra. Cotrni~cticrrtM e d i c d Jorrrnul, 20, 18-20.
Fig.
346
Short Case Report
Leukoplakia of the Male Urethra Leukoplakia of the renal pelvis, ureter, bladder, glans penis and vulva has been well documented but very little has been written about leukoplakia of the urethra, except to mention that it does occur. 8 cases have been reported-3 by Kretschmer (1928), 1 each by Schloss (1956) and Per1 (1965) and 3 by Reece and Koontz (1975). The following case is probably the first to be reported from the United Kingdom and has several unusual features.
cystitis, especially on the posterior wall. A small biopsy was taken from one of the white rings in the urethra. Histology showed the junction between regular transitional epithelium and hyperplastic, regular squamous epithelium covered by a thick surface band of keratin (Fig.). The appearance confirmed the diagnosis of leukoplakia of the urethra.
Comment
Apart from cases of leukoplakia of the bladder extending into the posterior urethra. all the reported cases of leukoplakia of the urethra have involved the distal segment of the anterior urethra. The disease in t h i b segment has invariably produced at least meatal stenosis, usually a long narrow stricture and occasionally a urethral diverticulum. The case reported is, therefore, unusual in that there was no meatal stenosis, only the bulbar urethra was involved and only slight narrowing of the urethra had occurred. N o specific treatment is being given to this patient, as he has no symptoms now and his urine has never been infected. He will be followed up carefully in case it stricturc develops and because ofthe known association between leukoplakia of the urinary tract and squamous carcinoma (O'Flynn and M ullaney, 1974).
Case Report A 23-year-old white man was admitted with a history
of haematuria with the passage of clots, slightly increased frequency and pain on micturition for 1 day. He had passed some blood in his urine when he was 3 years old but this had ceased spontaneously. His father had had haeniaturia the same year but the cause for this was not known. The only abnorniality to be found o n general examination was some suprapubic tenderness. Urine: Miscoscopy: more than 50 million WBCs and RBCs per litre. Culture: no significant growth. No tubercle bacilli on microscopy or culture. Cytology: atypical cells. I V P : the upper urinary tract was normal. C,~.rtortrc,r/irl)scupy. There were circular rings around the bulbar urethra extending over about 3 cm. These rings were slightly constricting the lumen and appeared white with some rough, raised nodules. The cystoscopc (21 F) passed easily through them. In the bladder there were patchy areas of haemorrhagic
P. VIJAYAN,P. B. CLARK and C. K . ANDERSON Drprrrtnient o f llroloig~~,The Gencwl / t i f i r n r w ~ j ~ ,
Lerds
References KRETSCHMER, H. L. (1928). Leucoplakia of the urinary organs. Srirgfwy, @8~ieidog.vc i n d Oh.ctrtric.>,47, 14s- I 54. O'FLYNN,J. D. and MULLANEY, J . (1974). Vesical leukoplakia progressing to carcinoma. British Joiirtrul of UroluK.v, 46, 31 -37. PERL,J. I. (1964). Intraluminal bcta irradiation in leukoplakia constricting the male urethra. Jorirnnl Of ui'OkJ&r.V 91,, 76-78. RI'ECE,R. W. and KOONTZ, W. W. (1975). Leukoplakia of the urinary tract-a review. Jorirnrrl of U ~ U / O R 114, > , 165-171. SCHLOSS,W. A. (1956). Leukoplakia of the male urethra. Cotrni~cticrrtM e d i c d Jorrrnul, 20, 18-20.
Fig.
346
