Routine cystoscopy prior to radical prostatectomy. Is it justified?

Yoram Mor, Llan Leibovitch, Jacob Ramon

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: The extent of the required preoperative evaluation 01 patients who are candidates for radical prostatectomy is still controverts! Traditionally, cystoscopy has been reserved only to those candidates who present with hematuria. Recently, several authors have reported significant incidental cystoscopic findings advocating routine cys'oscopy prior to radical prostatectomy. In view of the conflicting recommendations we assessed the role of routine preoperative cystoscopy jr. p.-ostate cancer patients. METHODS: We reviewed retrospectively the cystoscopic findings in 225 consecutive patients with organ confined adenocarcinoma of orostate who were candidates for radical prostatectomy. Rigid cystoscopy -.vas performed before radical prostatectorny either separately, in an cj'oat n' setting, or on the operating tab!e before the operation. RESULTS: Significant cystoscopic fincngs were noted in 3/225 patients (1.3%). A bladder stone was found in 1 patient (removed endosccpicaily prior to radical proststectomy). a bladder tumor was detected ii another patient and was resected preoperative!/. ;n a ihirci paiient a oroxi~al bulbar urethra! polyp containing prosiatic adenocarcinoma v/as resec'sd transurethrally and the patient was managed by irradiation due 'o the inc?' extension. Neither of those patients had microscopic hematuria :urinaiysis to suggest those findings. Cystoscopy was free of complication in all patients, apart from occasional mild hematuria. CONCLUSIONS: The management of patients with prostate cancer who are candidates for radical prostatectomy was affected by 'he preoperative cystoscopic findings in less than 1% of the cases. In an a when cost effectiveness considerations are a major issue, the low yield of cystoscopy in these patients does not justify its routine use prior to radical prostatectomy.

Original languageEnglish
Pages (from-to)262
Number of pages1
JournalBritish Journal of Urology
Volume80
Issue numberSUPPL. 2
StatePublished - 1997
Externally publishedYes

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