Prostate-Specific Antigen Evolution After Photoselective Vaporization of the Prostate

Abstract

The PSA level significantly decreased by half 1 month after the procedure, reached its nadir at 6 months, and showed a slight progressive reascension during the 4 following years. Applying an energy rate ≥4000 J/cc of prostate induced PSA stability over time whereas energy ≤3000 J/cc induced a reascension of the PSA level after 6 months.

Perioperative Changes and Progress in Photoselective Vaporization of the Prostate with GreenLight XPS 180 W System: A Single Center Experience

“…Likewise the energy density decreased more than 20%. These findings are in line with recently published data by Lebdai et al [16] as well as Rieken et al [17] showing a decreasing energy use in larger prostates. In 2016, Valdivieso et al [18] demonstrated that the energy density >3 kJ/m presents an important factor in achieving sufficient tissue vaporization leading to improved long-term outcomes with regard to IPSS + QoL, Qmax, and post-void retention [16, 18].…”

Photoselective Vaporization of the Prostate for Benign Prostatic Hyperplasia Using the 180 Watt System: Multicenter Study of the Impact of Prostate Size on Safety and Outcomes

“…1,22 In a previous study also using the HPS system we observed a 9% re-treatment rate at 12 months in patients with preoperative TRUS greater than 100 cc. 12,22 In the current study the re-treatment rates were significantly lower than previously reported, including 0.9% (4 of 462 cases) at 12 months and 1.2% (5 of 411) at 24 months. Although there was substantial loss at followup, these findings are notable when considering previously reported re-treatment rates.…”

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

“…Five (5.0%) patients were diagnosed with localized prostate cancer during the follow-up. Lebdai et al [19] assessed the PSA levels of 308 patients without prostate cancer who underwent PVP. They reported that the median PSA level decreased from baseline by 47% at 1 month, reached its nadir (52% reduction) at 6 months, and then exhibited a reduction of 44-52% from baseline at 4 years.…”

“…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]. …”

“…The re-increase in PSA after PVP may be related to the regrowth of the remaining adenoma, excluding prostate cancer [19]. It is unknown which patients should undergo prostate biopsy when a continuous PSA increase is observed during follow-up.…”