[Membranous and penile urethral involvement in bladder cancer patients-- review of cystoprostatourethrectomy specimens].

We studied 18 cystoprostatourethrectomy specimens, which were surgically removed for bladder cancer and step-sectioned in 0.5 cm thickness, to evaluate the relationship of the membranous and penile urethral lesions, with the multiplicity of bladder cancer, association of carcinoma in situ (CIS), bladder neck involvement, and prostatic involvement. Thirteen cases were associated with CIS. There were four solitary bladder cancers and 14 were with multiple cancers. Twelve cases were with bladder neck involvement and seven with prostatic involvement. There were five cases of urethral involvement; two cases of CIS and three with dysplasia. No macroscopic urethral cancers were detected in the urethra. Four of the five cases of urethral involvement had multiple cancers with CIS and were associated with bladder neck and prostatic involvement. One case of urethral dysplasia had solitary bladder cancer and neither bladder neck nor prostatic involvement were observed. Statistical analysis revealed that prostatic involvement was the only significant risk factor for urethral involvement. Our study shows that bladder cancer patients with prostatic involvement should be excluded from the candidates for bladder substitution utilizing the retained urethra. When a neobladder is indicated to bladder cancer patients, each case should be followed carefully for urethral recurrence.