A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 μm thickness were derived at a 100 μm interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 360° and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons

Primary malignant melanoma of the urinary bladder: Clinical, morphological, and molecular analysis of five cases

PubMedID: 27603550The aim of our study was to evaluate the clinical and morphological features of primary malignant melanomas of the urinary bladder. We obtained information on five such cases from three different institutions. These were three men and two women between 52 and 76 years of age. Three tumors presented with hematuria, one with dysuria, and one was discovered incidentally on imaging studies. All were invasive to muscularis propria on transuretral resections performed for diagnosis. Neoplastic cells showed variable patterns (large cell epithelioid, small cell diffuse, storiform, or mixed) in different tumors. Pigmentation was prominent in all except one case. Each case was labeled diffusely for S-100, HMB-45, and Melan-A. Pan-cytokeratin showed a perinuclear dot-like reaction in two tumors. Three cases showed the BRAF mutation in molecular studies. Two patients were already metastatic at the time of diagnosis. Two patients died, one is alive with disease after 15 months, and two patients are disease free at 1 and 5 years of surveillance. © 2016 Wolters Kluwer Health, Inc

Invasive Squamous Carcinoma and Adenocarcinoma of an Unreconstructed Exstrophic Bladder with Hpv Infection

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Squamous cell carcinoma of the penis: A clinicopathological study from a population with late circumcision

Squamous cell carcinoma (SCC) of the penis has been subject to only a few studies in populations where late childhood circumcision is performed. To asses clinicopathological features and human papillomavirus (HPV) status of penile SCC in men with late circumcision, eight institutions in the country volunteered to collaborate and 15 cases of penile SCC were collected from their pathology archives. The presence and genotype of HPV were determined in addition to clinicopathological features of the tumors. Findings were correlated with disease outcome. The mean age of the patients evaluated was 66.5 years. Histological subtypes were usual SCC (6/15), papillary (2/15), mixed (2/15), basaloid (2/15), acantholytic (1/15), pseudohyperplastic (1/15), and warty-basaloid (1/15) carcinomas. HPV was identified in 33.3% of samples; HPV16 was detected in 60% of positive cases and was associated with basaloid and/or warty morphology. Cause-specific 1-year and 2-year survivals were 76.9% and 54.5%, respectively. The usual subtype and nodal metastasis were associated with worse outcome (p=0.045 and p=0.047, respectively). As a conclusion, our results suggest an inclination for penile SCC to develop at a later age in a population with late circumcision than the patients from the regions of high penile cancer incidence. These men seem to have less frequent HPV association and their outcome appears poorer than other populations, although reaching substantial provision is not possible due to our limited case number. © 2019, Editura Academiei Romane. All rights reserved

Small cell Carcinomas of the bladder highly express somatostatin receptor type 2A: Impact on prognosis and treatment-a multicenter study of urooncology society, Turkey

Small cell carcinoma (SmCC) is a rare and aggressive neuroendocrine carcinoma of the bladder. Neuroendocrine carcinomas expressing somatostatin receptors (SSTR) in other viscera such as lung, pancreas, and gastrointestinal system respond to therapy with somatostatin analogs. In the present study, expressions of SSTRs 1 to 5 including type 2A are investigated by immunohistochemistry (IHC) and their relationship with clinicopathologic factors was evaluated. Hundred primary bladder SmCC cases were collected from 12 centers in Turkey. Forty-three cases were pure SmCC. Other cases had mostly papillary urothelial carcinoma as a second component. The percentage of the SmCC component ranged from 5% to 100%. SSTR-2A expression was membranous, whereas the other receptors showed cytoplasmic staining. The percentages of positive cases for SSTR-1, SSTR-2A, SSTR-3, SSTR-4, and SSTR-5 were 4% (3/75), 61.4% (54/88), 2.4% (2/84), 24.4% (20/82), and 6.25% (5/80), respectively. The percentage of SmCC component was positively correlated with the percentage of SSTR-2A expression (P=0.003) while negatively correlated with patient age (P=0.032). SSTR-2A expression was correlated with survival as a bad prognostic factor (P=0.018). SSTR-1, SSTR-3, SSTR-4, and SSTR-5 expressions did not show any statistical significance with any parameter. In conclusion, although the limited number of cases with adequate term follow-up, SSTR-2A expression could be a prognostic factor and somatostatin analogs therapeutic candidate for SmCCs of the bladder as these tumors show high percentage of SSTR-2A expression. © 2016 Wolters Kluwer Health, Inc. All rights reserved