Given the low incidence of urethral cancer, specific pathophysiologic considerations are unknown. However, it is thought that chronic inflammation, infection, or irritation of the urethra usually precedes the development of urethral cancer. Rapid turnover of the urethral mucosal cells predisposes to the development of dysplasia and neoplasia. Inflammation, infection, and irritation may also impede the natural DNA repair mechanisms of the urethral mucosal cells. The tumor usually invades deeply and metastasizes to adjacent structures. Since urethral cancer is often not diagnosed until late, the tumor can easily become elusive to definitive therapies such as surgery and radiation.