The Effect on Serum Prostate Specific Antigen after Transurethral Resection of Prostate for Benign Prostate Hypertrophy

Jeung, Hee Jong; Oh, Bong Ryoul; Moon, Jai Dong

Abstract

PURPOSE: It is important to know for transurethral resection of prostate (TURP) affecting the serum prostate specific antigen (PSA) value how long one should wait before being able to ~ obtain an accurate and meaningful serum PSA level. We evaluated the change of serum PSA concentration in patients with benign prostate hypertrophy(BPH) before and after TURP in association with time course and resected prostatic weight. MATERIALS AND METHOD: The effect of TURP was examined in 27 patients with BPH (mean age: 64 years; range: 55-79 years). The serum PSA levels were measured serially (before and 1, 3, 5, 7, 14, 30, 60, 90 days after TURP) by Abott IMX assay.
RESULTS
The level of serum PSA appeared to be consistent with prostatic volume by transrectal ultrasonography(TRUS) and was elevated by about 0.16 ng/mL for each gram of hyperplastic tissue present (p=0.375, p=0.058). TURP caused an immediate elevation in the serum PSA concentration, with a median increase of 19 ng/mL (p=0.0001). The larger resected group showed a dramatic and statistically significant PSA rise immediately after TURP than the smaller resected group (p=0.023). From the 15 post-operative day, the PSA concentrations continued slightly lower than that of pre-operative day (p=0.0001), and was still decreased on 30 days (p=0.0001). The median time to return to a baseline level of PSA was 30 days (range: 1460 days) after TURP.
CONCLUSION
These findings indicate that TURP caused an immediate increase in the serum PSA level, which generally return to stable, baseline level within 30 days. However, because in some patients the serum PSA still remained elevated than upper normal limit after 30 days, it is recommended that a serum PSA determination should be obtained for at least 60 days after TURP.