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Does urethral-sparing prostatectomy risk residual prostate cancer?
W P Tongco1, M S Wehner, J W Basler
1Division of Urology and Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229-3900, USA
Urology
|March 15, 2001
Summary
Urethral-sparing radical prostatectomy may improve urinary continence, but residual prostate adenoma in the urethra can affect prostate-specific antigen (PSA) monitoring. Patients and doctors must consider this residual tissue during follow-up.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Post-prostatectomy urinary continence is linked to urethral length.
- Sparing the prostatic urethra during radical prostatectomy may enhance continence.
Purpose of the Study:
- To assess the anatomical and pathological outcomes of urethral-sparing radical prostatectomy.
- To investigate the presence of residual prostate tissue in urethral specimens.
Main Methods:
- 12 patients with localized prostate cancer underwent bladder neck-sparing radical retropubic prostatectomy.
- Prostatic urethral specimens were dissected and sent for separate pathological examination.
Main Results:
- All urethral specimens contained residual benign prostate adenoma; none contained prostate cancer.
- Localized prostate cancer was confirmed in 7 of 12 prostatectomy specimens.
- Positive surgical margins were observed in 5 patients, with 2 having locally advanced disease.
Conclusions:
- Residual prostate adenoma is consistently found in urethral specimens after this procedure.
- The presence of residual adenoma may interfere with post-operative prostate-specific antigen (PSA) monitoring.
- The clinical significance and malignant potential of residual benign periurethral adenoma require further understanding.