What is the urethra? The urethra is part of the excretory system and is a thin fibromuscular tube through which urine from the bladder leaves the body. The male urethra (urethra masculina) is about 20 cm long and allows the passage of seminal fluid and urine. The female urethra (urethra feminina) is about 4 cm long and transports only urine. Malignant cells rarely arise in the urethra. In fact, urethral cancer is the rarest form of urological cancer. It accounts for less than 1% of all cancers. However, there is a slightly higher incidence of urethral cancer in men than in women. What are the symptoms of urethral cancer? In its early stages, urethral cancer may present with few or no symptoms. By the time symptoms appear, the cancer may already be in an advanced stage. The following signs and symptoms are associated with urethral cancer: Blood in the urine; Frequent urge to urinate, especially at night; Difficulty starting to urinate; Weak or intermittent (stop and go) flow of urine; Inability to hold urine (incontinence); Presence of discharge or bleeding from the urethra; A painless lump or swelling in the groin or penis. What are the causes of urethral cancer? The exact cause of urethral cancer is unknown, but human papillomavirus (HPV) infection, a history of sexually transmitted infections (STIs), and chronic irritation and inflammation of the urethra are associated with an increased risk of urethral cancer. Cancer of the urethra arises from three different types of cells, including: Squamous cells. Squamous cells are flat cells that line the surface of the urethra. Malignant changes occur most often in these cells, making squamous cell carcinoma the most common type of urethral cancer; Transitional epithelial cells. Transitional cells are located near the opening of the urethra in women and in the part of the urethra that passes through the prostate gland in men. Rarely, these cells can undergo malignant transformation and lead to urethral cancer; Gland cells. Adenocarcinoma is cancer of the glands that are found around the urethra in men and women. It accounts for less than 5% of all urethral cancers. Cancer of the urethra is highly aggressive and can quickly spread (metastasize) to local tissues around the urethra and other parts of the body if left untreated. It is important to make a quick diagnosis and start treatment as soon as possible. What are the risk factors for urethral cancer? A person may be at increased risk for urethral cancer if any of the following factors apply to them: Age over 60 years; Chronic irritation or inflammation of the urinary tract, especially in patients,who have recurrent urinary tract infections or sexually transmitted infections or require periodic catheterization; A history of urethral diverticulum (cavity or pocket in the wall of the urethra filled with urine or pus), polyps or urethral caruncle in women (a benign lesion in the distal parts of the urethra), and urethral strictures (narrowing of the lumen of the urethra due to the formation of a connective tissue in certain areas of it) in men; History of bladder cancer; Human papillomavirus (HPV) infection or history of other sexually transmitted infections; History of pelvic radiation (for example, X-rays) Knowing the signs of urethral cancer can help make the diagnosis as early as possible and start treatment as soon as possible. References: 1. Urology Care Foundation. Urethral cancer 2. Viswambaram P, Oey O, Swarbrick N, Hayne D. Adenocarcinoma of the urethra: A rare subtype of urethral cancer 3. Carlock HR, Spiess PE. Review on urethral cancer: what do you need to know