Changes in Serum Prostate-Specific Antigen Levels after Potassium-Titanyl-Phosphate (KTP) Laser Vaporization of the Prostate

Abstract

PurposeThe prostate-specific antigen (PSA) level decreases after transurethral resection of the prostate (TURP). However, changes in the PSA level after potassium-titanyl-phosphate (KTP) laser vaporization of the prostate are not well known. The aim of this study was to investigate the effect of KTP laser vaporization of the prostate on PSA levels in patients with benign prostatic hyperplasia (BPH).Materials and MethodsSerum PSA levels were checked before and 1, 3, 6, and 12 months after the procedure in patients who underwent KTP laser vaporization between October 2004 and August 2008. Patients with prostate cancer, a history of urinary retention, or prostatitis during the follow-up period were excluded. The results for 278 patients were studied.ResultsThe mean age of the patients was 69.0±6.7 years (range, 50-91 years) and the mean preoperative PSA level was 2.72±2.93 ng/ml. The PSA level tended to be increased at 1 month after the operation (3.18±3.23 ng/ml, p=0.032) but decreased within 3 months and became stabilized after 6 months at 1.79±1.82 ng/ml (p<0.001).ConclusionsPSA levels may increase after KTP laser vaporization for a certain period of time, but eventually decrease and become stabilized after 6 months. Therefore, it may be appropriate to wait up to 3 months if the PSA level rises after the procedure, and further investigation should be considered if the PSA level still remains high after 6 months.

Change in Free To Total Prostate Specific Antigen Ratio Following Transurethral Resection of Prostate in Patient With Benign Prostatic Hyperplasia

“…Another study reported that 2.93 ng/ml which tended to increase at I month after the operation (3.18 f 3.23 ng/ ml, p = 0.032) but decreased in the next 2 months and became stabilized at 1.79 ± 1.82 ng/ml after 6 months (p<0.001). In our study we also observed a significant reduction of total and free PSA in 3 months observation favouring the findings of the present study, but in our study both these parameters began declining after 7h postoperative day which not consistent with findings of Shim et al (2010) [14].…”

Prostate-Specific Antigen Evolution After Photoselective Vaporization of the Prostate

“…Only a few studies have assessed the PSA variations and their interpretation through time after PVP: Volkan and associates 2 first reported that the serum PSA level increased immediately after potassium-titanylphosphate (KTP) laser vaporization, then decreased and returned to its preoperative level within 15 days after the procedure. Shim and colleagues 3 reported the largest study assessing specifically the PSA evolution after PVP in a series of 278 patients treated by an 80 W KTP laser system. The PSA level increased the first month after the procedure and then decreased significantly over the next 3 months and became stable after 6 months.…”

“…In the same way, patients who present a serum PSA level that does not decrease enough or remains high or increases after PVP are supposed to be at risk of presenting with PCa. 3 PVP compared with TURP has the disadvantage of not providing any samples for histologic analysis, which might spoil an opportunity to detect PCa. Thus, it is all the more important to have proper knowledge of the PSA evolution after the procedure to not ignore a coexisting prostate malignancy and to define optimal follow-up strategies.…”

Optimal Monitoring of Prostate-Specific Antigen Detects Prostate Cancer at the Localized Stage after Photoselective Vaporization for Benign Prostatic Hyperplasia

“…With regard to changes in PSA levels after PVP, Shim et al [17] analyzed the PSA levels of 278 patients without prostate cancer who underwent PVP. They reported that the mean PSA level increased temporarily from baseline by 17% at 1 month and then began to decrease continuously afterward, showing decreases of 29 and 34% at 3 and 6 months, respectively, followed by stabilization between 6 and 12 months.…”

“…In our study, we also observed a re-increase in the mean PSA level after its nadir at 3 months. Although the reduction rates differ among reports, the mean PSA level after PVP was demonstrated to decrease after 1 month, reach its nadir at 3-6 months, and show stability or a slight re-increase thereafter [17,18,19,20,21]. …”