Prospective Study
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World J Clin Urol. Jul 24, 2014; 3(2): 144-151
Published online Jul 24, 2014. doi: 10.5410/wjcu.v3.i2.144
Alternative mechanisms for prostate-specific antigen elevation: A prospective analysis of 222 transurethral resections of prostate patients
Koenraad van Renterghem, JJMCH de la Rosette, Herbert Thijs, Erika Wisanto, Ruth Achten, Jean-Paul Ory, Gommert van Koeveringe
Koenraad van Renterghem, Department of Urology, Jessa Hospital, 3500 Hasselt, Belgium
JJMCH de la Rosette, Department of Urology, Academic Hospital Amsterdam, 1105 AZ Amsterdam, The Netherlands
Herbert Thijs, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Hasselt University, 3500 Hasselt, Belgium
Herbert Thijs, Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KULeuven, 3000 Leuven, Belgium
Erika Wisanto, Ruth Achten, Department of Pathology, Jessa Hospital, 3500 Hasselt, Belgium
Jean-Paul Ory, Department of Anesthesiology, Jessa Hospital, 3500 Hasselt, Belgium
Gommert van Koeveringe, Department of Urology, University Hospital Maastricht, 6229 HX Maastricht, The Netherlands
Author contributions: van Renterghem K contributed to the set up of the research, was the main author of the manuscript and responsible for the surgery and determination of PSA levels, International Prostate Symptoms Score, prostate weight, post residual volume and pressure flow parameters; de la Rosette JJMCH, Ory JP and van Koeveringe G contributed to the scientific advice, revision of data and writing of the manuscript; Thijs H contributed to the statistical analysis and writing of the manuscript; Wisanto E and Achten R contributed to the histopathological analysis and writing of the manuscript.
Correspondence to: Koenraad van Renterghem, MD, PhD, Department of Urology, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium. koenraad.van.renterghem@ageingmaleclinic.be
Telephone: +32-11-308991 Fax: +32-11-309998
Received: December 18, 2013
Revised: February 14, 2014
Accepted: March 11, 2014
Published online: July 24, 2014
Processing time: 213 Days and 0.2 Hours
Abstract

AIM: To investigate the relationship between prostate-specific antigen (PSA) levels and (1) bladder outlet obstruction (BOO) and (2) the severity of prostate inflammation.

METHODS: Two hundred and twenty-two consecutive patients undergoing transurethral resection of the prostate (TURP) were prospectively included. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score (IPSS), prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed.

RESULTS: Patients had a mean age of 69.1 ± 8.6 years (45-90 years), with mean preoperative PSA levels of 4.7 ± 5.4 ng/mL (0.2-32.5 ng/mL) and IPSS of 15.7 ± 6.9 (0-32). Mean PdetQmax was 96.3 ± 34.4 cmH2O (10-220 cmH2O). The mean resected prostate weight was 39.4 ± 27.3 g (3-189 g). Correlations were observed between PSA (logarithmic) and resected prostate weight (r = 0.54; P < 0.001), PSA (logarithmic) and PdetQmax (r = 0.17; P = 0.032), and resected prostate weight and PdetQmax (r = 0.39; P < 0.001). Furthermore, low correlations were observed between PSA (logarithmic) and active (r = 0.21; P < 0.0001) and chronic (r = 0.19; P = 0.005) inflammation.

CONCLUSION: In this study we showed a correlation between BOO (PdetQmax) and PSA (logarithmic). Furthermore, we demonstrated a weak correlation between PSA (logarithmic) and active as well as chronic prostatic inflammation.

Keywords: Transurethral resection of the prostate; Prostate-specific antigen; Bladder outlet obstruction; Lower urinary tract symptoms; Prostate inflammation

Core tip: The goal was to investigate the relationship between prostate-specific antigen (PSA) levels and (1) bladder outlet obstruction (BOO) and (2) the severity of prostate inflammation. We performed a prospective study on 222 consecutive patients undergoing transurethral resection of the prostate. Patients with proven urinary tract infection and/or known prostate cancer were excluded. PSA levels, International Prostate Symptoms Score, prostate weight, post residual volume and pressure flow parameters were determined. A histopathological assessment of the presence and severity of inflammation was also performed. In this study we showed a correlation between BOO (PdetQmax) and PSA (logarithmic). Furthermore, we demonstrated a weak correlation between PSA (logarithmic) and active as well as chronic prostatic inflammation.