Effects of Benign Prostatic Diseases on the Level of Serum Prostate Specific Antigen

Im, Jin Dong; Lee, Sang Kon

Abstract

PURPOSE: Prostatic specific antigen (PSA) may be elevated in patients with benign prostatic diseases. We evaluated the causes of elevated serum prostatic specific antigen concentration in men without prostatic carcinoma by periodic determination of serum PSA.
MATERIALS AND METHODS
From January 1996 to December 2000, of the 85 patients with elevated serum PSA (>4 ng/ml), 53 (62.4%) had clinical evidence of benign prostatic diseases such as BPH or acute prostatic inflammation. In 47 patients serum PSA was measured every 1-4 weeks until the PSA returned to base line level.
RESULTS
In 42 (89.4%) patients the serum PSA concentration decreased to less than 4 ng/ml. within 3 months. The recovery rate of serum PSA within 4 weeks was high at 69% (29 of 42). The base line PSA was greater than 4 ng/ml during the follow-up period of 3 months in five patients. An elevation of PSA by acute prostatic inflammation (mean 34.1 40.0ng/ml) was abrupt and significantly greater than by prostatic hyperplasia (12.4 9.4 ng/ml, p=0.026). In patients with BPH, an initial elevation in serum PSA correlated with prostatic volume (r2=0.211, p=0.036), but no significant correlations between prostatic volume and elevated PSA levels were observed in patients with acute prostatic inflammation (r2=0.051, p=0.480).
CONCLUSIONS
Benign prostatic hypertrophy and acute prostatic inflammation were main benign causes for serum PSA elevation. Majority of patients with elevated PSA by benign causes returned to base line less than 4 ng/ml in 4 weeks. However in some patients the serum PSA still remained elevated after 4 weeks, who should undergo TRUS guided biopsy of prostate to rule out the presence of malignancy. We recommended to wait at least 6 weeks for a repeat PSA determination.