Pathological review of internal genitalia after anterior exenteration for bladder cancer in women. Evaluating risk factors for female organ involvement.

To evaluate cancer involvement of internal female genitalia of patients undergoing anterior exenteration for clinically organ confined transitional cell carcinoma of the bladder, and identify potential preoperative risk factors. Charts and anterior exenteration specimens from 54 women with clinically organ confined transitional cell bladder cancer were retrospectively reviewed. Emphasis was given to the presence of internal genitalia involvement and or primary gynecologic pathology. Unsuspected internal genitalia involvement was reported in only three patients (5.7%). The vagina was involved in two cases (3.8%) while the uterus in one (1.9%). In all cases involvement was due to direst extension from bladder tumors of the base and dome respectively. No preoperative variable could predict internal genitalia involvement in a statistical significant manner. Benign pathology of the female reproductive organs was observed in six patients and involved in all cases the uterus (11.5%). Internal genitalia involvement after radical cystectomy for TCC tumors of the bladder is rare (5.8%). Preoperative risk factors could not be identified although all involved genitalia were seen in tumors of the bladder dome and base. Therefore large multi-institutional studies are needed in order to identify preoperative risk factors for internal genitalia involvement in females with bladder cancer.