Transurethral resection of the prostate (PG056)

Pathomorphological examination after transurethral resection (TUR) of the prostate — is a detailed histological study of fragments of prostate tissue ("shavings") obtained using an electrosurgical instrument through the urethra. This study is mandatory after operations aimed at restoring normal urination in benign prostatic hyperplasia (adenoma).

Research objective: The main task of the pathologist is to confirm the benign nature of the tissue growth and, most importantly, to exclude incidental (incidentally discovered) prostate cancer. Since TUR is often performed without a prior biopsy, it is this analysis that allows you to make sure that the symptoms of adenoma are not hidden by a malignant process.

What does the pathologist evaluate:

• Histological variant of hyperplasia: determining the predominance of the glandular, muscular or fibrous component (important for understanding the nature of the disease).

• Exclusion of adenocarcinoma: thorough search for malignant cells in the entire volume of the submitted material.

• Volume of tumor lesion (if found): assessment of the percentage of tissue involved (stage $T1a$ or $T1b$ according to the TNM classification).

• Gleason score: If cancer is detected, the degree of its aggressiveness must be calculated.

• Presence of inflammation: diagnosis of concomitant chronic or acute prostatitis, signs of prostate infarction or granulomatous changes.

Clinical significance: The conclusion with the code PG056 determines the further tactics of patient supervision. If only benign hyperplasia is confirmed, the patient is considered cured of obstruction. In case of detection of latent cancer, the urologist decides on the need for radical surgery, radiotherapy or dynamic observation (depending on the aggressiveness and volume of the tumor found).

When is it prescribed:

• after elective prostate TUR surgery for benign prostatic hyperplasia (BPH);

• when removing prostate tissue to eliminate urinary retention;

• in cases of ineffective drug treatment of lower urinary tract symptoms;

• as a diagnostic step for suspected prostate cancer if biopsy is technically impossible.