Cystoprostatectomy grossing

This article deals with how to cut-up cystoprostatectomy specimens.

Introduction

Cystoprostatectomies are done for bladder cancer. Granular areas of the bladder often correlate with carcinoma in situ.

Specimen:

Type: cystoprostatecomy.
Specimen weight: ___ grams.
Specimen dimensions (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
Prostate dimensions (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
Left seminal vesicle: ___ x ___ x ___ cm.
Right seminal vesicle: ___ x ___ x ___ cm.

Tumour:

Size of tumour (superior-inferior, left-right, anterior-posterior): ___ x ___ x ___ cm.
Location of tumour: [dome, left, right, anterior, posterior, trigone].
Nearest margin: [soft tissue margin / urethral / ureteric ].
Distance to nearest margin: ___.
Configuration: [ulcerated / exophytic].
Appearance: [tan/brown / white], [firm / friable].
Extension into perivescicular adipose tissue: [not identified, present].

Representative sections:

Urethral resection margin on edge.
Ureteral surgical (or specimen) margins (left and right).
Sagittal section of posterior prostate, posterior bladder neck and posterior-inferior bladder divided into multiple blocks.
Left prostate - mid part of gland.
Right prostate - mid part of gland.
Left parasagittal section of the bladder neck and prostate gland.
Right parasagittal section of the bladder neck and prostate gland.
Bladder tumour - 1 section/cm.
- Section with deepest invasion.
- One section if fat invasion obvious, three sections if it is suspicious.
Suspicious granular areas.
Left bladder wall.
Right bladder wall.
Anterior bladder wall.
Posterior bladder wall.
Dome of bladder.
Trigone of bladder.

The parasagittal sections of the bladder and prostate are important for staging.