PROSTATE SPECIFIC ANTIGEN LEVEL FOLLOWING TRANSURETHRAL RESECTION OF THE PROSTATE

##plugins.themes.bootstrap3.article.main##

##plugins.themes.bootstrap3.article.sidebar##

PDF
Published 2020-01-22
Johannes Aritonang Zulfikar Ali

Abstract

Objective: To evaluate the correlation of the weight of the resected prostate with the reduction of the PSA level. Material & methods: This is a prospective study of all BPH patients undergoing TURP procedure in Kardinah Hospital, Tegal, with a timeframe of April–June 2018. Patients consumed α-blocker and 5-α reductase inhibitor medication before the procedure were eliminated from the study. The data collected were the estimated prostate weight calculated using transabdominal ultrasonography (TAUS) of the prostate, PSA level before and after the procedure, and the calculated weight of the resected prostate. The resected tissues of the prostate were examined by an anatomy pathologist and the PSA level will be examined at 1, 14, and 30 days after the surgery. Data was analyzed using repeated measure ANOVA with SPSS version 23.0. Results: We included 35 cases of prostate enlargement in our center. 2.8% of the patients didn’t undergo definitive surgical procedure due to be postponed with various reasons. The patients mean age is 64.2 ± 8.26 with average BMI is 21.8 ± 3.56kg/m2. The median value of the prostate volume is 43.8 mL. The median preoperative PSA level was 8.7 ng/dL, while the median value of the 1st day, 14th days, and 30th days post-operative PSA level were17.67 ng/dL, 6.93 ng/dL, and 3.2 ng/dL, respectively, with significant reduction of PSA level (p<0.001). Conclusion: PSA level post-TURP shows a significant decrease. Every milliliters (mL) prostatic tissue resected could reduce the PSA level for 0.11 ng/mL. This calculation could further be used to predict how much tissue needed to resect, to treat the symptoms, and obtain normal PSA level. In addition, further research is needed, especially with larger sample size and longer follow up period to confirm these findings.


##plugins.themes.bootstrap3.article.details##

Keywords

benign prostate hyperplasia, prostate specific antigen, resection of the prostate

References

Park SC, Shin YS, Zhang LT, Kim DS, Kim SZ, Park NC, et al. Prospective investigation of change in the prostate-specific antigens after various urologic procedures. Clin Interv Aging. 2015; 10: 1213–8.

Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E. Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med. 1987; 317(15): 909–16.

Etzioni RD, Howlader N, Shaw PA, Ankerst DP, Penson DF, Goodman PJ, et al. Long-term effects of finasteride on prostate specific antigen levels: Results from the prostate cancer prevention trial. J Urol. 2005; 174(3): 877–81.

Gravas S, Bach T, Bachmann A, Drake M, Gacci M, Gratzke C, et al. Guidelines on the management of male lower urinary tract symptoms Benign Prostatic Obstruction ( BPO ). Eur Assoc Urol; 2014.

Antunes AA, Srougi M, Coelho RF, Leite KR, Freire G de C. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: How much should be resected? Int Braz J Urol. 2009; 35(6): 683–9.

Baten E, van Renterghem K. The advantages of transurethral resection of the prostate in patients with an elevated or rising prostate specific antigen, mild or moderate lower urinary tract symptoms, bladder outlet obstruction and negative prostate cancer imaging or prostate biopsies. Curr Urol. 2016; 10(3): 140–4.

DynaMed. Ipswich (MA): EBSCO Information Services. 1995 - 2018. Record No. 116944, Benign prostatic hyperplasia (BPH); [updated 2017 Jul 05, cited June 20th 2018]; [about 50 screens].Available from http://search.ebscohost.com/login.aspx?direct=true&db=dnh&AN=116944&site=dynamed live&scope=site. Registration and login required.

Verhamme KMC, Dieleman JP, Bleumink GS, Lei J Van Der. European urology incidence and prevalence of lower urinaryt ract symptoms suggestive of benign prostatic hyperplasia in primary careöthet riumph project. 2002; 42: 323–8.

Wang S, Mao Q, Lin Y, Wu J, Wang X, Zheng X, et al. Body mass index and risk of BPH : a meta-analysis. 2012; (December 2010): 265–72.

Pahwa M, Pahwa M, Pahwa AR, Girotra M, Chawla A, Sharma A. Changes in S-PSA after transurethral resection of prostate and its correlation to postoperative outcome. Int Urol Nephrol. 2013; 45(4): 943–9.

Aus G, Bergdahl S, Frösing R, Lodding P, Pileblad E, Hugosson J. Reference range of prostate-specific antigen after transurethral resection of the prostate. Urology. 1996; 47(4): 529–31.

Cho HJ, Shin SC, Cho JM, Kang JY, Yoo TK. The role of transurethral resection of the prostate for patients with an elevated prostate-specific antigen. Prostate Int. 2014; 2(4): 196–202.

Kaplan SA, Mcconnell JD, Roehrborn CG, Meehan AG, Lee MW, Noble WR, et al. Combination therapy with doxazosin and finasteride for benign prostatic hyperplasia in patients with lower urinary tract symptoms and a baseline total prostate volume of 25 Ml or greater. 2006; 175(January): 217–21.

Lloyd SN, Collins GN, McKelvie GB, Hehir M, Rogers ACN. Predicted and actual change in serum PSA following prostatectomy for BPH; 1994. p. 472–9.

Marks LS, Dorey FJ, Rhodes T, Shery ED, Rittenhouse H, Partin AW, et al. Serum prostate specific antigen levels after transurethral resection of prostate: A longitudinal characterization in men with benign prostatic hyperplasia. 1996; 1035–9.

Section
Articles
Copyright Information
Department of Urology, Faculty of Medicine/Airlangga University