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Abstract Background Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can spread through blood and lymphatic circulation to distant parts of the body. Case presentation A 58-year-old non-smoker male presented with gross and microscopic hematuria. His family history included his father’s recent bladder cancer. Initial investigations showed hematuria, inflammation, negative urine culture, digital rectal examination revealed an enlarged right lobe of the prostate, and an elevated Prostate-Specific Antigen level. Histopathological examination of samples taken from the bladder mucosa and the prostate confirmed urothelial carcinoma in situ in the bladder and prostate. Further evaluation revealed no other metastasis. The tumor was classified as T4aN0M0. The patient underwent radical cystoprostatectomy and histopathological examination showed that the tumor invading the muscularis propria of the bladder as well as the prostatic glands, but no malignancy was found in prostatic urethra and other areas. The patient was discharged three weeks post-operation and completed on adjuvant chemotherapy consisting of Gemcitabine, and Cisplatin to prevent of relapse. The patient is currently in a good healthy. Conclusion The occurrence of bladder cancer metastasizing to the prostate without involving the prostatic urethra is uncommon and requires precise diagnostic techniques for accurate tumor classification. Early management is advised to enhance the prognosis for the patient.

Purpose: The external urethral sphincter (EUS) is critical for urinary continence, but its complex anatomy is not fully understood, complicating its preservation during prostate surgeries. This study aims to elucidate the anatomy and development of the EUS to enhance surgical techniques for continence preservation. Methods: The study consisted of a postmortem examination of three male cadavers, aged 52, 64, and 60, with intact urogenital systems. Specimens including the prostate and EUS were dissected, fixed in formalin, and stained with Hematoxylin-Eosin for microscopic analysis. Histological assessments focused on the muscle composition and structure of the EUS and prostate. Results: Macroscopic examination revealed symmetrical prostates without pathologies. Histologically, the anterior prostate lacked tubuloalveolar glands, showing striated muscle fibers from the external urethral sphincter extending into the prostate and prostatic urethra. Reduced glandular structure and prevalent smooth muscle were noted. This intricate integration of striated muscle fibers at the EUS-prostate interface underscores the anatomical complexity vital for surgical preservation of urinary continence. Conclusion: Our study reveals a complex EUS-prostate relationship, challenging the view of the EUS as merely a circular muscle. The findings demonstrate the importance of the EUS's extension into the prostate for urethral stabilization and continence. Recognizing this anatomy is crucial for maintaining urinary continence in prostate surgeries and enhancing postoperative outcomes. [ABSTRACT FROM AUTHOR]

Background: Carcinoma in situ of the bladder is a high-grade cancer that originates in the superficial layer of the bladder. It has the potential to invade nearby organs, and it can spread through blood and lymphatic circulation to distant parts of the body. Case presentation: A 58-year-old non-smoker male presented with gross and microscopic hematuria. His family history included his father's recent bladder cancer. Initial investigations showed hematuria, inflammation, negative urine culture, digital rectal examination revealed an enlarged right lobe of the prostate, and an elevated Prostate-Specific Antigen level. Histopathological examination of samples taken from the bladder mucosa and the prostate confirmed urothelial carcinoma in situ in the bladder and prostate. Further evaluation revealed no other metastasis. The tumor was classified as T4aN0M0. The patient underwent radical cystoprostatectomy and histopathological examination showed that the tumor invading the muscularis propria of the bladder as well as the prostatic glands, but no malignancy was found in prostatic urethra and other areas. The patient was discharged three weeks post-operation and completed on adjuvant chemotherapy consisting of Gemcitabine, and Cisplatin to prevent of relapse. The patient is currently in a good healthy. Conclusion: The occurrence of bladder cancer metastasizing to the prostate without involving the prostatic urethra is uncommon and requires precise diagnostic techniques for accurate tumor classification. Early management is advised to enhance the prognosis for the patient. [ABSTRACT FROM AUTHOR]

Introduction. The most common treatment option for prostate cancer is radical prostatectomy, which involves the removal of the prostate itself and the prostatic urethra in a single block, followed by the formation of a vesicourethral anastomosis. This approach is fraught with postoperative complications, such as urinary incontinence and strictures of anastomosis. In this sense, the clinic's staff faced the question of the possibility of a urethral-sparing variant of operative benefit for a certain category of patients.Objective. To assess the possibility of performing radical prostatectomy with sparing of the proximal prostatic urethra in the laparoscopic version, its advantages, and disadvantages.Materials & methods. From 2021 to 2022, 18 successful laparoscopic operations were performed using this technique at the St. Luke Clinical Multidisciplinary Medical Centre. Patients were selected according to the above criteria. In the preoperative period, patients underwent a standard examination in accordance with guidelines, including a blood test for prostate-specific antigen (PSA), ultrasound, magnetic resonance imaging (MRI) with 3D-modelling, data from a multifocal prostate biopsy, the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF), the Quality of Life (QoL) index due to urinary disorders, assessment by the Partin’s nomogram. Intraoperative ratios, early and late postoperative complications, length of hospital stay, day of catheter removal, and time to complete urethral recovery were evaluated to study the effectiveness of this surgery type. PSA testing, uroflowmetry with post-void residual urine measurement and IPSS questionnaire were carried out one month after surgery.Results. There was an improvement in all measurements one month after surgery: median values of the mean urine flow rate increased by 1.7 ml/s, median values of the max urine flow rate increased by 3.7 ml/s, the IPSS decreased by 12 points.Conclusion. Based on the results of the study, clinical observations, and statistical analysis of the data obtained, it can be concluded that laparoscopic radical prostatectomy with sparing of the proximal prostatic urethra is the preferred surgical option for this pathology, due to its organ-preserving nature.

Prostatic urethra identification is crucial in prostate stereotactic body radiotherapy (SBRT) to reduce the risk of urinary toxicity. Although computed tomography (CT) with a catheter is commonly employed, it is invasive, and catheter placement may displace the urethral position, resulting in possible planning inaccuracies. However, magnetic resonance imaging (MRI) can overcome these weaknesses. Accurate urethral identification and minimal daily variation could ensure a highly accurate SBRT. In this study, we investigated the usefulness of a three-dimensional (3D) T2-weighted (T2W) sequence for urethral identification, and the interfractional motion of the prostatic urethra on CT with a catheter and MRI without a catheter for implementing noninvasive SBRT. Thirty-two patients were divided into three groups. The first group underwent MRI without a catheter to evaluate urethral identification by two-dimensional (2D)- and 3D-T2W sequences using mean slice-wise Hausdorff distance (MSHD) and Dice similarity coefficient (DSC) of the contouring by two operators and using visual assessment. The second group provided 3-day MRI data without a catheter using 3D-T2W, and the third provided 3-day CT data with a catheter to evaluate the interfractional motion using MSHD, DSC, and displacement distance (Dd). The MSHD and DSC for the interoperator variability in urethral identification and visual assessment were superior in 3D-T2W than in 2D-T2W. Regarding interfractional motion, the Dd value for prostatic urethra was smaller in MRI than in CT. These findings indicate that the 3D-T2W yielded adequate prostatic urethral identification, and catheter-free MRI resulted in less interfractional motion, suggesting that 3D-T2W MRI without a catheter is a feasible noninvasive approach to performing prostate SBRT. [ABSTRACT FROM AUTHOR]

Introduction. Existing methods of surgical treatment of benign prostatic hyperplasia are accompanied by the frequent development of postoperative complications, such as urinary incontinence, retrograde ejaculation, and urethral strictures. The method of preserving the prostatic urethra has been developed for a long time. At present, it is possible to use the operation technique and perform laparoscopic urethral-sparing adenomectomy.Objective. To assess the possibility of performing extraurethral adenomectomy with prostatic urethral preservation using the laparoscopic approach, its advantages and disadvantages.Materials and methods. Based on St. Luke’s Simferopol сlinical Multidisciplinary Medical Center, 35 successful laparoscopic operations were performed to remove benign prostate hyperplasia with the prostatic urethra preservation. The features of the operation are laparoscopic access, a transverse section of the capsule, alternate isolation of adenomatous nodes while preserving the prostatic urethra on the catheter without replacing it during the operation, suturing the capsule with a decrease in space from the removed adenomatous nodes. Urethral preservation provided accelerated epithelialization of the defect, in the absence of the formation of a “prevesical” space.Results. After the operation, it is possible to turn off the urinary bladder irrigation system earlier (up to 4 – 6 hours after the operation) and early removal of the catheter after surgery (2 – 3 days). The hospital stay averaged 5.7 days. Urination was restored immediately after catheter removal in 92% of the patients. There were no elements of dysuria, particularly urinary incontinence. Prostate volume measured throughout transrectal ultrasound after operation was 20 – 24 cm³.Conclusion. The technique of retropubic extraurethral adenomectomy with prostatic urethral preservation can be performed in laparoscopic technique. The advantages are early activation of the patient and discharge from the hospital, early removal of the catheter with restoration of independent urination, absence of dysuria, urinary incontinence, and postoperative complications. The results of our study demonstrate the effectiveness of the laparoscopic extraurethral adenomectomy technique, the further development of this technique, and the possibility of its application in practice.

A 70-year-old male underwent a Transurethral Resection of Prostate for the management of obstructive voiding symptoms. On cystoscopy, papillary frond-like lesions up to 2cm in size were encountered, overlying the right side of the prostatic urethra. Histopathology from the resection revealed clear cell adenocarcinoma (CCA) of the prostatic urethra.Primary clear cell adenocarcinoma of the prostatic urethra is exceedingly rare, with as few as 9 cases reported. We review the literature for its oncogenesis, discuss the histopathological features for diagnosis and report on our surgical management and outcome.

Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular tumor rarely found in the genitourinary tract. Here, we present a case of a 6-year-old boy presenting with gross hematuria who was found to have a mass at the bladder base on ultrasound. Endoscopic resection was performed, revealing the base of the mass originating from the prostatic urethra. Pathology found pyogenic granuloma. This entity has not previously been reported to arise from the pediatric urethra and should be considered on the differential for children presenting with gross hematuria and those found to have bladder or urethral masses.

In this rare case we report a 3-week-old boy with postnatal continues stomach pains, crying and severe dysuria, caused by bladder outlet obstruction due to a histopathological confirmed fibroepithelial polyp in the prostatic urethra. The condition was diagnosed and fully treated with ultrasound and a therapeutic cystoscopy.

BACKGROUND: The primary carcinoma of the urethra was described for the first time in the year 1834, it represents less than 0.5% of malignant neoplasms in men, it is subdivided into primary and secondary, when it is located for the first time in this site it represents the primary form, the Secondary occurs when there is a history of previous injury to the urethra or any site of the urinary tract. CLINICAL CASE: We present the case of a 27-year-old diabetic male, who began two months before the biopsy due to obstructive urinary symptoms, hematuria and dysuria was reported as a poorly differentiated primary adenocarcinoma of the urethra with a signet ring cell component, CK 7 positive, in which a primary lesion in another genitourinary site, prostate, lung, and gastrointestinal tract was ruled out. CONCLUSION: This case is interesting because it is a rare and aggressive tumor, in stage T2 due to invasion of prostate tissue. Although the prognosis of the disease is poor, some patients may benefit from surgical resection, especially those with tumors originating in the proximal urethra; chemotherapy should be discussed with a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Urinary bladder cancer is frequently multifocal and has a high incidence of recurrence. Although the prostatic urethra is a frequent site of tumor relapse in patients with non‐muscle‐invasive bladder cancer treated with TURBT, such tumors are often underdiagnosed. Here we present two cases having urethral recurrence after TURBT. [ABSTRACT FROM AUTHOR]

We present a young adult male patient with suspicious lesion in urinary bladder found on routine exam using ultrasound. Urethrocystoscopy was performed and revealed urethral fibroepithelial polyp that was causing partial and total obstruction of urine flow. We have documented this case with a series of high-quality endoscopic images.

Abstract Urinary bladder cancer is frequently multifocal and has a high incidence of recurrence. Although the prostatic urethra is a frequent site of tumor relapse in patients with non‐muscle‐invasive bladder cancer treated with TURBT, such tumors are often underdiagnosed. Here we present two cases having urethral recurrence after TURBT.

The presence of villous adenoma in the urinary tract is an exceedingly rare finding. On a histological and cytological level, this tissue is essentially identical to that typically found in the colon. These lesions do have malignancy potential and, when present with coexistent adenocarcinoma, have a risk of recurrence and metastasis even after surgical resection. Although villous adenomas of the urinary tract have been almost exclusively treated with surgical intervention in the literature, we present a case of villous adenoma with underlying adenocarcinoma of the prostatic urethra that was successfully treated with combined chemoradiation therapy. While surgical excision has been shown to be curative in diseases with isolated villous adenoma, more aggressive treatment with radiation and/or chemotherapy can be considered in patients with concurrent adenocarcinoma. However, more research into this subject is required to properly determine the best choice of therapy for this niche patient population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Corsi et al.)

Stromal–epithelial interactions are critical to the morphogenesis, differentiation, and homeostasis of the prostate, but the molecular identity and anatomy of discrete stromal cell types is poorly understood. Using single‐cell RNA sequencing, we identified and validated the in situ localization of three smooth muscle subtypes (prostate smooth muscle, pericytes, and vascular smooth muscle) and two novel fibroblast subtypes in human prostate. Peri‐epithelial fibroblasts (APOD+) wrap around epithelial structures, whereas interstitial fibroblasts (C7+) are interspersed in extracellular matrix. In contrast, the mouse displayed three fibroblast subtypes with distinct proximal–distal and lobe‐specific distribution patterns. Statistical analysis of mouse and human fibroblasts showed transcriptional correlation between mouse prostate (C3+) and urethral (Lgr5+) fibroblasts and the human interstitial fibroblast subtype. Both urethral fibroblasts (Lgr5+) and ductal fibroblasts (Wnt2+) in the mouse contribute to a proximal Wnt/Tgfb signaling niche that is absent in human prostate. Instead, human peri‐epithelial fibroblasts express secreted WNT inhibitors SFRPs and DKK1, which could serve as a buffer against stromal WNT ligands by creating a localized signaling niche around individual prostate glands. We also identified proximal–distal fibroblast density differences in human prostate that could amplify stromal signaling around proximal prostate ducts. In human benign prostatic hyperplasia, fibroblast subtypes upregulate critical immunoregulatory pathways and show distinct distributions in stromal and glandular phenotypes. A detailed taxonomy of leukocytes in benign prostatic hyperplasia reveals an influx of myeloid dendritic cells, T cells and B cells, resembling a mucosal inflammatory disorder. A receptor–ligand interaction analysis of all cell types revealed a central role for fibroblasts in growth factor, morphogen, and chemokine signaling to endothelia, epithelia, and leukocytes. These data are foundational to the development of new therapeutic targets in benign prostatic hyperplasia. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Cystitis glandularis is a proliferative disease of the bladder epithelium usually presenting in the setting of chronic inflammation, characterized by the formation of glands in the bladder mucosa and submucosa. Intestinal metaplasia is a described process in cystitis glandularis characterized by the presence of intestinal cells and mucin production which is rare as compared to cystitis glandularis. We present a case of cystitis glandularis with intestinal metaplasia located in the bladder and concomitantly in the prostatic urethra. Patient underwent transurethral resection of the lesion which was unusually found in the prostatic urethra. Florid cystitis glandularis is a rare condition found in women more than in men. It usually presents with irritative lower urinary tract symptoms or hematuria which leads to its eventual diagnosis. It is usually causes by inflammation to the bladder mucosa due to infections or irritation. Patients are diagnosed through Transurethral resection of these bladder lesions found in the trigone and bladder neck region. Surgery is the standard treatment of choice. However, medical treatment may also be used to treat underlying inflammatory conditions using antibiotics, steroids, and non-steroidal anti-inflammatory agents. Radical or partial cystectomy may be performed for severe refractory cases. This article describes the rare occurrence of florid cystitis glandularis in the prostatic urethra and provides an overview on diagnosis, etiology, and management of the disease. • Cystitis glandularis with intestinal metaplasia is a rare finding in the urinary system. • Intestinal metaplasia may occur secondary to inflammation, or due to embryogenic remnants. • This condition is observed more frequently in women than in men in the bladder neck and trigone area. • Treatment options are available such as medical treatment and surgical treatment. • Partial or radical cystectomy may be performed in severe and recurrent cases of florid cystitis glandularis. [ABSTRACT FROM AUTHOR]

BackgroundMucin-producing urothelial-type adenocarcinoma of the prostatic urethra is extremely rare. These lesions must be differentiated from other mucinous tumors including mucin-producing prostatic adenocarcinoma and metastases from either colonic or bladder primaries.Case presentationWe report here a case of urothelial-type adenocarcinoma arising from the prostatic urethra. The patient is an 81 year-old man with a history of pT1 urothelial cell carcinoma of the bladder status post trans-urethral resection of bladder tumor (TURBT) who initially presented with irritative lower urinary tract symptoms and mucosuria refractory to Flomax and finasteride. A shared decision was made for the patient to undergo trans-urethral resection of prostate (TURP). At the time of surgery, a papillary tumor emanating from the prostatic urethra was found and no urothelial lesions were noted in the bladder. Pathology of the resected prostatic chips revealed an invasive adenocarcinoma with intestinal-type differentiation that stained positive for CK7, CK20, and villin, but negative for PSA, PSAP, uroplakin, and CDX-2. Colonoscopy was normal and CT scan did not show any evidence of colonic lesions nor visceral or lymph node metastases. Thus, the patient was diagnosed with a primary urothelial-type adenocarcinoma of the prostatic urethra.ConclusionHerein we review the literature regarding this unusual entity, and discuss the differential diagnosis, immunohistochemistry, and the importance of correctly identifying this rare tumor.

Introduction: The aim of this study was to perform a quantitative assessment of the prostate anatomy with a focus on the relation of prostatic urethral anatomic variation to urinary symptoms.Methods: This retrospective study involved patients undergoing magnetic resonance imaging for prostate cancer who were also assessed for lower urinary tract symptoms. Volumetric segmentations were utilized to derive the in vivo prostatic urethral length and urethral trajectory in coronal and sagittal planes using a piece-wise cubic spline function to derive the angle of the urethra within the prostate. Association of anatomical factors with urinary symptoms was evaluated using ordinal univariable and multivariable logistic regression with IPSS score cutoffs of ≤7, 8-19, and >20 to define mild, moderate, and severe symptoms, respectively.Results: A total of 423 patients were included. On univariable analysis, whole prostate volume, transition zone volume, prostatic urethral length, urethral angle, and retrourethral volume were all significantly associated with worse urinary symptoms. On multivariable analysis prostatic urethral length was associated with urinary symptoms with a normalized odds ratio of 1.5 (95% confidence interval 1.0-2.2, p = 0.04). In a subset analysis of patients on alpha blockers, maximal urethral angle, transition zone volume as well as urethral length were all associated with worse urinary symptoms.Conclusion: Multiple parameters were associated with worse urinary symptoms on univariable analysis, but only prostatic urethral length was associated with worse urinary symptoms on multivariable analysis. This study demonstrates the ability of quantitative assessment of prostatic urethral anatomy to predict lower urinary tract symptoms. [ABSTRACT FROM AUTHOR]

A potential late side effect of high-dose-rate (HDR) prostate brachytherapy combined with external beam radiotherapy (EBRT) is urethral stricture. The purpose of this study was to evaluate dosimetric parameters possibly contributing to stricture development, including dose to bladder base and D2cc(Gy) within 10 mm of prostatic urethra (D2cc 10 mm), which has, so far, not been reported in the literature. Patients developing urethral stricture, and matched controls, were identified from a prospective database of those receiving 46 Gy in 23 fractions of EBRT, followed by a single 15 Gy HDR brachytherapy dose. Patients had locally advanced, high- and intermediate-risk prostate cancer. Brachytherapy treatment planning parameters (planning target volume (PTV) size (cm 3), V110(%) bladder base , D2cc 10mm , number of HDR catheters, number of source dwell positions, and total source dwell time within 10 mm of the prostatic urethra) were analyzed to determine potential risk factors for urethral stricture. Seventy-two patients were treated, 22 of whom developed a urethral stricture. Univariate logistic regression performed on the planning parameters identified increased PTV size and D2cc 10 mm , with decreased V110(%) bladder base as risk factors for stricture formation. It is suggested that PTV size, V110(%) bladder base , and D2cc 10mm are predictive of urethral stricture formation following EBRT and brachytherapy to the prostate. This study demonstrates the importance of minimizing high dwell times and hot spots close to organs at risk and also the correction of any craniocaudal movement of catheters to avoid potential hot spots in the bulbomembranous urethra where there may be increased dose sensitivity. [ABSTRACT FROM AUTHOR]

ABSTRACT Acute Urinary Retention (AUR) caused by urological malignancy is a rare event, even in elderly. A solitary prostatic urethral Transitional Cell Carcinoma (TCC) causing retention of urine is even rarer. Hereby, a case of 60-year-old non-smoker, with sudden onset of AUR was reported. Detailed clinical examination, biochemical and radiological investigations were not conclusive. Cystoscopy revealed a solitary papillary prostatic urethral growth projecting from base probably causing urinary retention. Histopathology confirmed it as a low grade urothelial carcinoma. Patient voided well after complete transurethral resection. Hence, an urothelial malignancy can have varied presentation, and appropriate histological diagnosis with cross-sectional imaging and regular follow-up with cystoscopy is mandatory.

Introduction: Knowledge of the prostatic portion of the urethra is essential to the comprehension of urinary continence phenomena. However, there are only a small number of studies that have addressed this relationship and analyzed the ultrastructure of the prostatic urethra.Material and Methods: A three-dimensional analysis of the fibrous components and the extracellular matrix of the prostatic urethra in 10 normal humans was performed with a scanning electron microscope. The prostates were obtained from 10 men (18 to 30 years old) who had died from accidents. The specimens were fixated in a modified Karnovsky solution for 48 h at 4°C, washed in a sodium phosphate buffered solution (PBS) for 2 h at 4°C and then incubated in 40 ml of 2 M NaOH at room temperature for 8 days (cellular digestion). Afterwards, the three-dimensional organization of the prostatic urethra stroma was observed.Results: It was observed that the prostates had a narrowed fibrous septa which condensed and formed a network in order to support the submucosa. Furthermore, it was also observed that they formed a homogeneous fibrous layer (pars fibroreticularis), which lined the urethral wall.Conclusions: Knowledge of the urethra composition is essential to understand the physiopathological aspects of urinary incontinence. Moreover, our results showed a great amount of connective tissue underlying the prostatic urethra wall. [ABSTRACT FROM AUTHOR]

Purpose: Non-muscle-invasive bladder cancer involving the prostatic urethra is associated with pathologic upstaging and shorter survival. We investigated the survival impact of prostatic urethral involvement in non-muscle-invasive patients who are not upstaged at cystectomy. Methods: From 2000 to 2016, 177 male patients underwent cystectomy for high-risk non-muscle-invasive bladder cancer and remained pT1, pTis, or pTa, and N0 on final pathology; 63 (35.6%) patients had prostatic urethral involvement and 114 (64.4%) did not. Prostatic involvement was non-invasive (Ta or Tis) in 56 (88.9%) patients and superficially invasive (T1) in 7 (11.1%) patients. No patient had stromal invasion. Log-rank and Cox regression analyses were used to evaluate survival. Results: Compared to patients without prostatic urethral involvement, patients with involvement were more likely to have received intravesical therapy (84.6% vs. 64.4%, p < 0.01), have multifocal tumor (90.8% vs. 51.7%, p < 0.01), and have positive urethral margins (7.7% vs. 0%, p < 0.01) and ureteral margins (18.5% vs. 5.1%, p < 0.01). Log-rank comparison showed inferior recurrence-free, cancer-specific, and overall survival in patients with prostatic involvement (p = 0.01, p = 0.03, p < 0.01). Patients with prostatic urethral involvement were more likely to experience recurrence in the urinary tract (p < 0.01). On Cox regression, prostatic urethral involvement was an independent predictor of overall mortality (HR = 2.08, p < 0.01). Conclusions: Prostatic urethral involvement is associated with inferior survival in patients who undergo cystectomy for non-muscle-invasive bladder cancer and remain pT1, pTis, or pTa on final pathology. Prostatic urethral involvement is thus an adverse pathologic feature independent of its association with upstaging. [ABSTRACT FROM AUTHOR]