ABSTRACT

Urothelial cancers of the prostate is rarely encountered in the absence of bladder involvement and it significantly impacts management decisions and prognosis. The prostate is involved with Urothelial cancers in up to 48%of patients undergoing radical cystoprostatectomy for bladder cancer and is the primary source of Urothelial cancer in a small number (3%) of patients. Treatment of urothelial carcinoma involving the prostatic ducts is controversial. Ductal invasion of the prostate is not currently an absolute indication for radical cystoprostatectomy. Intravesical BCG has a 70-100%success rate in patients with CIS. Recurrent acinar and ductal carcinoma may be treated more aggressively and radical cystoprostatectomy should be pursued. Although debate exists regarding optimal therapy for mucosal involvement, if the prostatic stroma is involved, radical cystoprostatectomy is the treatment of choice.