<p><strong> </strong><strong>In patients with high-risk NMIBC in the prostatic urethra who decline radical cystectomy and elect for intravesical therapy, clinicians should perform a repeat TUR of the prostatic urethra to improve staging accuracy and optimize the efficacy of subsequent intravesical therapy. (<em>Expert Opinion</em>) </strong></p>
Discussion
Discussion
<p>The presence of prostatic urethral involvement by high-grade urothelial carcinoma has been associated with worse outcomes. In patients undergoing cystectomy, its presence is associated with worse cancer-specific mortality.<sup>162</sup> Patients should be counseled on cystectomy as a treatment option. Rates of complete response when managed with TURBT/transurethral resection of the prostate (TURP) followed by intravesical therapy vary greatly in previous reports from 48-86.6%.<sup>163</sup> If patients with high-grade urothelial carcinoma of the prostatic urethra are to be managed with TURBT and intravesical therapy rather than cystectomy, the general recommendation is to repeat a resection to include a TUR of the bladder neck and prostatic urethra to improve staging accuracy, exclude stromal involvement, and facilitate exposure of the prostatic urethra to intravesical therapy.</p>