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[Can the prostatic capsule be preserved during cystectomy for bladder tumors: a study of urethral and prostatic
P Plante1, A Lesourd, P Blanchet
1Groupe Tumeur de vessie infiltrante du CCAFU, Service d'Urologie, CHU Rangueil, Toulouse, France.
Objectives:
To evaluate the frequency of urethral and prostatic lesions on cystectomy specimens for bladder tumour.
Material And Methods:
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.
Results:
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.
Conclusion:
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.