Radikal sistoprostatektomi oncesi alınan prostatik uretral TUR biyopsiler ve intraoperatif frozen biyopsilerin değeri ve uretral rekurrens

Abstract

In this study, the value of preoperative TUR biopsies takenfrom prostatic urethra of the patients that have had radical cystoprostatectomy because of bladder cancer in determining the prostatic urethral involvement and the effect ofprostatic urethral TUR biopsy with intraoperative frozen biopsy of surgical margin of prostatic urethra in selecting the type of urinary diversion and urethral recurrence areinvestigated. 35 male patients were included into the study. Prostaticurethral TUR biopsies before the cystoprostatectomy operation and intraoperative prostatic urethral surgical margin biopsies were taken from all of the patients. In radical cystoprostatectomy materials; superficial involvement in prostatic urethra was found in 9 (25.7%)patients and in 26 (74.3%) patients there were no prostatic urethral involvement. The sensitivity of TUR prostatic biopsies for determining the prostatic urethral involvement is78%, the specificity is 92%, positive predictive value is 78% and the negative predictive value is 92%. 33 (94.3%) of the prostatic urethral surgical margin biopsies that are takenintraoperatively were negative and 2 (5.7%) were positive. There was prostatic urethral involvement in 2 patients who had a positive surgical margin previously. The predictive value of preoperative TUR biopsies taken from prostatic urethra for determining the involvement ofprostatic urethra is high and useful for informing the patients about the type of urinary diversion. The superficial involvement of prostatic urethra is not an indication forurethrectomy and also it is not an handicap for orthotopic diversion. Biopsy specimens that are taken intraoperatively from prostatic urethral surgical margin is effective for determining urethral surgical margin involvement and decision for performing an urethrectomy and also orthotopic urinary diversion.