Urethral specimens are usually received with bladder from cystectomy procedures. However occasional urethrectomy resections occur for primary malignant tumours or bladder cancer extension. Resection may also be required to treat urethral stricture. 1,2

Record the patient identifying information and any clinical information supplied together with the specimen description as designated on the container. See overview page for more detail on identification principles.

Fresh tissue received
  • No
    • Non-routine fixation (not formalin), describe.
  • Yes
    • Special studies required, describe.
    • Ensure samples are taken prior to fixation.
Intraoperative consultation
  • Not performed
  • Performed, describe type and result
    • Frozen section
    • Imprints
    • Other, describe

See general information for more detail on specimen handling procedures.

Inspect the specimen and dictate a macroscopic description.

External InspectionBack to top

Orientate and identify the anatomical features of the specimen.

Orientation markers

Record additional orientation or designation provided by operating clinician:

  • Absent
  • Present
    • Method of designation (e.g. suture, incision)
    • Featured denoted

Photograph the intact specimen if required.

Describe the following features of the specimen:


Record as stated by the clinician.
  • Urethrectomy
    • Partial
    • Total
  • Other, describe

Specimen integrity

  • Intact
  • Disrupted, describe
    • Number of fragments

Specimen size (mm)

  • Each fragment
    • Length
    • Diameter

If additional anatomical components are included, specify and measure according to relevant tissue protocol.

DissectionBack to top

Paint the circumferential resection margin (adventitial connective tissue) with ink and record the colours applied.

Serially section transversely at 3mm intervals maintaining sequential order from proximal to distal.

Lay the sections out sequentially and photograph to record a block key.

Internal InspectionBack to top

Describe the internal or cut surface appearance including the following items:


  • Absent
  • Present
    • Number; if more than one tumour, designate and describe each tumour separately

Tumour size (mm)

  • Maximum dimension
  • Other dimensions

Tumour description

  • Plaque/thickening
  • Ulcer
  • Stricture
  • Nodule
  • Papillary

Tumour site 

(more than one may apply)


  • Penile
  • Bulbomembranous
  • Prostatic
  • Undetermined


  • Anterior
  • Posterior
  • Undetermined    

Tumour invasion

  • Absent
  • Present
    • Urethral wall
    • Peri-urethral tissues
  • Depth (mm)

Distance to margins (mm)

  • Distance of tumour to closest "cut-end" margin
    • Specify margin if orientated (proximal/distal)
  • Distance of tumour to circumferential margin
Lymph nodes

Retrieved from resection specimen

  • Describe site(s)
  • Number retrieved

Separately submitted

  • For each specimen container, record specimen number and designation
  • Collective size of tissue in three dimensions (mm)
  • Number of grossly identified lymph nodes submitted
  • Maximum diameter of each (mm)

ProcessingBack to top

Submit representative sections of: 1-3

  • Tumour including deepest point of penetration
  • Other lesions (ulcer one section, more of warty lesions or stricture)
  • Proximal and distal surgical resection margins

Alternatively, submit the entire specimen for processing in sequential order with instructions to indicate the surface to be cut (e.g. ink marking of the obverse surface). This will allow mapping of the tumour and any associated carcinoma in situ which may be more extensive than apparent macroscopically.

Submit all lymph nodes.

Record details of each cassette.

An illustrated block key similar to the one provided may be useful.

Block allocation key

Cassette id
No. of pieces
Proximal margin
Tumour deepest point of invasion
Distal margin


A/Prof Hemamali Samaratunga for her contribution in reviewing and editing this protocol.

ReferencesBack to top

  1. O’Rourke D, Turner G and Allen D. Tissue Pathways for Urological Pathology, The Royal College of Pathologists, London, 2010.
  2. Shanks JH, Chandra A, McWilliam L and Varma M. Dataset for tumours of the urinary collecting system (renal pelvis, ureter, bladder and urethra) The Royal College of Pathologists, London, 2013.
  3. McKenney JK, Amin MB, Epstein JI, Grignon DJ, Oliva E, Reuter VE, Srigley JR and Humphrey PA. Protocol for the examination of specimens from patients with carcinoma of the urethra, Cancer Committee, College of American Pathologists, 2012.