THE ROLE OF CYSTOSCOPY BEFORE RADICAL PROSTATECTOMY

Objective To determine the role of pre-operative cystoscopy in men und ergoing radical prostatectomy for clinically localized adenocarcinoma of the prostate.Patients and methods One hundred men undergoing radica l prostatectomy for clinically localized adenocarcinoma of the prostat e were evaluated for coexisting bladder pathology from a retrospective review of their charts and records. Results Four of 100 men undergoin g radical prostatectomy for clinically localized prostate cancer were found to have synchronous bladder tumours, Two of these had superficia l low-grade transitional cell carcinoma (TCC), one had a poorly differ entiated invasive TCC and the last was found to have an inverted papil loma during radical retropubic prostatectomy, The patient with invasiv e disease died before the initiation of definitive therapy. The other three men are free of disease 2 years after diagnosis and treatment. C onclusion Because of the low cost and minimal morbidity of pre-operati ve flexible cystoscopy, we recommend that this procedure be performed on the operating table before prostatectomy, In patients with gross or microscopic haematuria, a significant history of smoking, a prior his tory of urothelial malignancy or symptoms of bladder outlet obstructio n, cystoscopy would be best performed before surgery in an outpatient setting.