The effect of seminal vesicle-sparing radical prostatectomy on serum prostate-specific antigen level.

Abstract

To investigate if the remaining seminal vesicle tips can affect serum levels of prostate-specific antigen (PSA) in patients after seminal vesicle-sparing radical prostatectomy (SVRP). Thirty-six patients were treated by either radical retropubic prostatovesiculectomy (23) or SVRP (13). Serum PSA was monitored in all patients before surgery, and at 6 weeks and 30 months afterward. Samples of normal seminal vesicles from radical cystectomies (six) were also snap-frozen and either processed for semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR) using primers against PSA and alpha-actin (for normalization) or for PSA immunohistochemistry. RT-PCR and sequencing showed that the seminal vesicles synthesise PSA mRNA. Furthermore, PSA peptide was detectable in the glandular epithelium of the seminal vesicle using immunohistochemical methods. There was no significant difference in serum PSA levels after standard or SVRP, with median (range) values (ng/mL) at 6 weeks of 0.04 (0.04-0.9) and 0.04 (0.04-0.66) and at 30 months of 0.17 (0.04-3.8) and 0.22 (0.04-58.2), respectively. Although the seminal vesicles produce PSA, the PSA derived from the remaining seminal vesicle tips after SVRP has no effect on the oncological follow-up of these patients.