Introduction: Prostate specific antigen (PSA) screening for prostate cancer has recently been challenged due to poor sensitivity. A number of conditions elevate PSA besides prostate cancer with benign prostatic hypertrophy (BPH) being most common. The objective of this study was to assess the positive predictive value (PPV) of PSA and PSA density (PSAD) for prostate cancer risk following Holmium laser enucleation of the prostate (HoLEP). Methods: An institutional IRB-approved database of HoLEP surgeries performed at Indiana University from 1999 to 2018 was queried to identify 1147 patients with post-HoLEP PSA data. 55 post-HoLEP biopsies were recorded. Demographics, PSA, prostate volume, and oncologic details were analyzed. The primary outcome was biopsy proven prostate cancer.
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