Uropathology

The close interaction between the pathologist and the urologist is essential for accurate pathological diagnosis of several urological cancers. The adoption of the new grading system in transitional cell carcinoma (TCC) of the bladder introduced by the World Health Organisation in 1998/ 1999, will improve the accuracy of pathological diagnosis of this cancer beyond the 61% already reported. Frozen section biopsy during cystectomy can be advocated in certain cases for urethral margin and lymph node biopsies, but not for ureteric margin biopsy. With regard to prostate cancer, this article describes in detail the careful steps required in the taking and handling of biopsy samples in order to maximise the histopathological diagnosis. These include a practice that has been advocated for some time - the separating of individual biopsy cores. Testicular cancer is discussed from the point of view of preserving the function of the testes, particularly with regard to intra-testicular and incidentally identified masses. Finally, partial nephrectomy for renal cell carcinoma (RCC) is discussed. Data suggest that multifocality is the main cause of local recurrence with this procedure. Consequently, preoperative and intraoperative evaluation in RCC are mandatory in order to identify multifocality.