Are Biopsies From the Prostatic Urethra Useful in Patients With Superficial Bladder Carcinoma?

Abstract

Fifty male patients entered a Mitomycin C trial for superficial bladder cancer and biopsies in the prostatic urethra were taken with a cold cup biopsy forceps. In one patient this procedure failed. In 2 1 of 49 patients no abnormalities were detected but in the remaining 28 patients (57.1%) histological changes were found in the prostatic urethra. In 13 of these patients (26.5%) the changes were either carcinoma in situ (CIS) or superficial bladder carcinoma.Carcinoma in situ in the prostatic urethra was found in nine patients ( 18%) and in all but one it was combined with CIS in the bladder.These results indicate that biopsies from the prostatic urethra must be taken routinely in order to plan adequate therapy.

Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma

“…Therefore, an early identification of prostatic involvement is significant in deciding the proper management of bladder cancer. Several investigators have recommended transurethral cold cup or resection biopsy of the prostatic urethra as the optimal technique to detect prostatic involvement in high‐risk patients, including those with carcinoma in situ of the bladder, particularly with involvement of the trigone or bladder neck 2,17,18 . We usually carry out transurethral deep resection biopsy of the prostate as well as cold cup biopsy of prostatic urethra to identify prostatic involvement in patients with carcinoma in situ of the bladder, repeated intravesical recurrence of multifocal, papillary and superficial bladder cancer, muscle‐invasive bladder cancer and a positive urine cytology despite normal bladder urothelium proved cystoscopically and by cold cup biopsy.…”

Prostatic biology, histologic patterns and clinical consequences of transitional cell carcinoma

“…Lockhart et al [22] suggested that in patients with nonmuscle invasive bladder cancer, involvement of prostatic urethra indicated the presence of aggressive tumor and that therapy should be instituted accordingly, including cytology, cystoscopy, and prostatic urethral biopsy; subsequently, Rikken et al [23] advocated that biopsies from the prostatic urethra should be taken routinely in order to plan adequate therapy. Similarly, Hardeman et al [24] studied 63 patients with superficial bladder cancer treated by intravesical therapy.…”

“…Apicalprostate sparing may be considered an option as well [23]. More recently, Salem [33 ] described a novel approach to preservation of sexual function performing a nervesparing radical cystoprostatectomy with preservation of the distal ends of the vasa deferentia anastomosis to the bulbar urethra in four potent men.…”