Changes of Serum Prostate-Specific Antigen before and After Transurethral Vaporization of Prostate for Benign Prostatic Hyperplasia

Abstract

We conducted this prospective study in order to assess the effect of transurethral vaporization of the prostate(TUVP) on the serum level of prostate-specific antigen(PSA). Thirty patients (average age: 70.5 yr, range: 62-80) with symptomatic benign prostatic hyperplasia(BPH) and negative rectal examination for hard nodule were included for evaluation. Transrectal ultra-sonography(TRUS) and serum PSA were checked in every patient before surgery. Biopsy was done if PSA was greater than 10 ng/ml or f suspicious lesion was detected by TRUS. Serum PSA in the morning(ELISA PSA II method-monoclonal antibody) was checked before TUVP, and at 20 h, 2, and 4 weeks after TUVP. Serum PSA values(mean±SD) were 5.3±4.2, 20.5±9.1, 5.1±3.1, and 3.6±2. 3 ng/ml, respect-tively. Estimated prostate weights were 33.8±14.0g. PSA was elevated 3.85 times at 20 h after TUVP and then decreased gradually after that. Of the 30 patients, the PSA level returned to less than pre-operative level 2 wk after surgery in 10 cases (33.3%), and 4 weeks after surgery in the other 26 cases (86.7%). PSA level at 20 h after TUVP correlated well with the estimated weight of the prostate(by TRUS) and preoperative PSA status (r=0.83 and 0.82, respectively, p＜0.05). Serum PSA increased significantly at 20 h after TUVP then decreased gradually. The degree of postoperative PSA increase was higher for larger prostates and for patients with higher preoperative PSA levels. We recommend that checking serum PSA is preferably done at least 4 wk after TUVP to avoid influence from the surgical procedure.