Can the prostatic capsule be preserved during cystectomy for bladder tumors: a study of urethral and prostatic involvement in the cystectomy specimens
Plante, P.; Lesourd, A.; Blanchet, P.; Castagnola, C.; Coloby, P.; Daffer, N.; Davin, J.L.; Desgrandchamps, F.; Irani, J.; Marechal, J.M.; Mottet, N.; Pariente, J.L.
Progres en Urologie Journal de l'Association Francaise d'Urologie et de la Societe Francaise d'Urologie 8(1): 47-50
1998
ISSN/ISBN: 1166-7087 PMID: 9533151 Document Number: 495969
To evaluate the frequency of urethral and prostatic lesions on cystectomy specimens for bladder tumour. This retrospective histological study was based on 260 specimens: radical cystectomies performed in 7 operative sites. The prostate and urethra were analysed in 3 planes (upper, middle and lower thirds). The apex was studied separately. Urethral invasion was identified by continuity of the tumour or by the presence of vesical CIS. Urethral involvement is frequent (30.6% cases) essentially due to contiguous invasion (43/80). CIS is the second pathological association (44 urethral CIS/75 bladder CIS). Prostatic adenocarcinoma was present in 17.8% of cases with a Gleason score > 6 for 30% of lesions. The high frequency of urethral and prostatic involvement does not justify preservation of the prostate during cystectomy. A serial prospective study should define the precise criteria able to minimize the risk of conservative surgery.
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