Effect of ejaculation on Serum Prostate-Specific Antigen concentration

Abstract

Purpose:To evaluate the effect of ejaculation on serum prostate-specific antigen (PSA) concentrations in patients with lower urinary tract symptom (LUTS).Materials and Methods Our study includes 98 men (62 study and 36 control). After three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels. Then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total (tPSA), free (fPSA) and complexed PSA (cPSA) levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation.Results The mean age in study and control groups patients were 59.03±0.99 years, 61.14±1.30 years, respectively. In the study group, changes in tPSA and fPSA levels after ejaculation were found statistically significant while changes in cPSA levels and f/tPSA ratios were not significant (p=0.016, p=0.0003, p=0.176, and p=0.173, respectively). Baseline values showed significant differences with 1st and 5th hours. No significant changes in tPSA, fPSA, cPSA levels and f/tPSA values were found in control group (p=0.223, p=0.224, p=0.444, and p=0.718, respectively). The changes in the number of patients exceeding the cutoff values after ejaculation were not statistically significant for tPSA, cPSA, and f/tPSA ratio.Conclusions In this study, ejaculation increased tPSA and fPSA concentrations but it didn’t have a significant effect on serum cPSA levels and f/tPSA ratios. However, recent ejaculation may affect the biopsy indication at least near cut off PSA values. Further studies are needed to explain the mechanisms of alterations in the concentration of PSA.

Ejaculation Effect on Canine Prostatic Specific Esterase Serum Concentration

“…Also in human medicine, ejaculation has been claimed to be one of the factors affecting PSA values, and its effect has been evaluated in several studies, reporting at first conflicting results with increased, unchanged, or decreased PSA concentrations after ejaculation [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Nevertheless, in works reporting decreased or unchanged PSA concentrations, sampling time intervals after ejaculation were too long (1 to 7 days after ejaculation) to detect early PSA elevations, which are instead observed during the very first hours [21]. Recently, it was definitively stated that the serum concentration of PSA increases at 1 h after ejaculation and returns to baseline values at 24 h [20,21,29] in 92% of patients [27].…”

“…Nevertheless, in works reporting decreased or unchanged PSA concentrations, sampling time intervals after ejaculation were too long (1 to 7 days after ejaculation) to detect early PSA elevations, which are instead observed during the very first hours [21]. Recently, it was definitively stated that the serum concentration of PSA increases at 1 h after ejaculation and returns to baseline values at 24 h [20,21,29] in 92% of patients [27]. The present study demonstrated that 24 h after ejaculation, increased serum CPSE came back to basal values in 90% of tested animals, following a trend similar to that reported for PSA in human medicine [20,21,27,29].…”

“…Recently, it was definitively stated that the serum concentration of PSA increases at 1 h after ejaculation and returns to baseline values at 24 h [20,21,29] in 92% of patients [27]. The present study demonstrated that 24 h after ejaculation, increased serum CPSE came back to basal values in 90% of tested animals, following a trend similar to that reported for PSA in human medicine [20,21,27,29]. The relationship between basal and post-ejaculation CPSE is the same in negative dogs (group A), and in positive animals, i.e., those either suspected to have or diagnosed with glandular BPH-related diseases (group B); no statistically significant differences were found in CPSE mean concentrations for both groups between T0 and T2.…”

“…The present study showed that the higher basal concentrations of CPSE are, the higher the post-ejaculatory peak; they are both more pronounced in subjects affected by prostatic disorders. In human medicine, too, the rise of PSA concentrations after ejaculation is more pronounced in men with larger prostate volumes and higher original PSA [21]. A hypothesis explaining higher PSA and CPSE concentrations in elderly patients states that the described physiologic barrier can weaken, becoming more permeable, resulting in the passage of higher amounts of PSA [21] and CPSE into the bloodstream.…”

“…In human medicine, too, the rise of PSA concentrations after ejaculation is more pronounced in men with larger prostate volumes and higher original PSA [21]. A hypothesis explaining higher PSA and CPSE concentrations in elderly patients states that the described physiologic barrier can weaken, becoming more permeable, resulting in the passage of higher amounts of PSA [21] and CPSE into the bloodstream. Moreover, in subjects with BPH-related disorders, ductal obstruction, acinar dilatation, and secretion retention might increase PSA [20,21] and CPSE leakage during ejaculation.…”