Prostate specific antigen levels following transurethral resection of the prostate

Abstract

Objective: Determine how serum prostate-specific antigen (t-PSA) levels and free PSA (f/t PSA) ratio change following transurethral resection of the prostate (TURP). Results: Clinical improvement after TURP, reflected by I-PSS score, was demonstrated as early as 30 days and remained stable until the end of the follow-up. Mean t-PSA declined 71% after TURP and 60 days after surgery the reduction reached its peak, stabilizing afterwards. It varied from 6.19 ± 7.06 ng/mL before surgery to 1.75 ± 1.66 ng/mL on day 60 (p < 0.001). The mean baseline f/t PSA ratio was 18.2% ± 3.4% and was not significantly changed at any given time point in the postoperative period (p = 0.91). There were also no statistically significant differences in t-PSA or f/t PSA between patients with and without prostatitis at any time point (p = 0.23). Resected prostate fragments weighed 29.9 ± 19.6 g, corresponding to 39.1% of the estimated preoperative prostate volume. Each gram of tissue resected decreased PSA by 0.15 ± 0.11 ng/mL, while 1% prostate volume resected led to a reduction of 2.4% ± 0.4% in serum PSA from baseline. Conclusions: PSA decreases drastically in patients who undergo TURP. These low levels stabilize within 60 days after surgery. The f/t PSA ratio did not change, and the finding of chronic prostatitis did not affect the levels of these variables.

Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected?

“…Studies have shown that PSA decreases drastically in patients who undergo TURP. Fonseca et al (16), showed that mean PSA levels declined 71% after TURP, and 60 days after surgery the reduction reached its peak, stabilizing afterwards. Mean PSA varied from 6.1 ng/mL before surgery to 1.7 ng/mL after 60 days postoperatively.…”

Paroxysmal atrial fibrillation during acute myocardial infarction associated with subclinical hyperthyroidism, severe three vessels coronary artery disease and elevation of prostate-specific antigen after TURP

“…It has been reported that sub-clinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes [4] but it is sufficient to induce an increase in atrial fibrillation rate [5] and increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state [6]. It has also been reported that serum prostate-specific antigen (PSA) decreases drastically in patients who undergo transurethral resection of the prostate (TURP) [7]. We present a case of paroxysmal atrial fibrillation during acute myocardial infarction associated with subclinical hyperthyroidism, severe three vessels coronary artery disease and elevation of PSA after TURP in a 78-year-old Italian man.…”

The high-powered holmium laser to treat benign prostatic hyperplasia

“…In larger prostates, it has also been shown that PSA can be reduced by 90% [ 23 ], an amount similar to that achieved with open prostatectomy. A recent study demonstrated that PSA is reduced by 71% after TURP [ 24 ]. In contrast, PSA is only reduced by 30%-42% after ablation with a potassium-titanyl-phosphate (KTP) laser [ 25 , 26 ].…”