Inverted papillomas of the prostatic urethra.

Area of Science:

• Urology
• Pathology
• Oncology

Background:

• Inverted papillomas (IPs) are rare benign neoplasms of the genitourinary tract.
• Data on IPs originating in the prostatic urethra are particularly limited.
• This study comprehensively evaluates IPs of the prostatic urethra.

Purpose of the Study:

• To characterize the demographic, clinical, and histopathologic features of inverted papillomas in the prostatic urethra.
• To assess the association of prostatic urethral IPs with prostate cancer and other prostatic pathologies.
• To evaluate the recurrence rate and malignant potential of prostatic urethral IPs.

Main Methods:

• Retrospective review of 21 cases of inverted papilloma of the prostatic urethra.
• Analysis of patient demographics, presenting symptoms, and diagnostic methods.
• Histopathologic evaluation, including assessment of associated prostatic pathologies and urothelial carcinoma.

Main Results:

• The mean patient age was 65.1 years; 47.6% presented with hematuria or irritative symptoms, while 52.4% were incidental findings during prostate cancer or benign prostatic hypertrophy (BPH) work-up.
• Histologically, 67% showed classic IP architecture, with some cases exhibiting squamous metaplasia or papillary features.
• Eleven cases had concurrent prostatic pathologies, including adenocarcinoma (n=6). Two patients had synchronous high-grade urothelial carcinoma of the bladder. Only one recurrence was noted among 18 patients with follow-up.

Conclusions:

• Inverted papillomas of the prostatic urethra are benign lesions.
• They are frequently detected incidentally and not associated with a history of urothelial malignancy.
• While synchronous urothelial carcinoma can occur, malignant transformation or recurrence of IP as a malignant lesion has not been observed.