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Management of elevated prostate-specific antigen in men with nonbacterial chronic prostatitis

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Abstract

Elevated serum prostate-specific antigen (PSA) in the setting of acute or chronic bacterial prostatitis is common. Serum PSA, however, is much more variable in the setting of chronic nonbacterial prostatitis. Because elevated serum PSA is associated with prostate cancer and is used in screening programs for prostate cancer, patients with benign causes for elevation of serum PSA present a challenge. This article reviews the management of patients with elevated serum PSA and a diagnosis of chronic nonbacterial prostatitis.

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References and Recommended Reading

  1. Albin RJ, Soanes WA, Bronson P, Witebsky E: Precipitating antigens of the normal human prostate. J Reprod Fertil 1970, 22:573–574.

    Article  Google Scholar 

  2. Kuriyama M, Wang MC, Papsidero LD, et al.: Quantification of prostate specific antigen in serum by a sensitive enzyme immunoassay. Cancer Res 1980, 40:4658–4662.

    PubMed  CAS  Google Scholar 

  3. Lilja H: A kallikrein-like serum protease in prostatic fluid cleaves the predominant seminal vesicle protein. J Clin Invest 1985, 76:1899–1903.

    Article  PubMed  CAS  Google Scholar 

  4. Lilja H, Oldbring J, Rannevik G, Laurell CB: Seminalsecreted proteins and their reactions during gelation and liquefaction of human semen. J Clin Invest 1987, 80:281–285.

    Article  PubMed  CAS  Google Scholar 

  5. Lilja H: Significance of different molecular forms of serum PSA: the free, noncomplexed form of PSA versus that complexed to alpha-1-antichymotrypsin. Urol Clin North Am 1993, 20:681–686.

    PubMed  CAS  Google Scholar 

  6. Catalona WJ, Partin AW, Slawin KM, et al.: A multicenter clinical trial evaluation of free PSA in the differentiation of prostate cancer from benign disease. JAMA 1998, 279:1542–1547.

    Article  PubMed  CAS  Google Scholar 

  7. Lieberman R: Evidence-based medical perspectives: the evolving role of PSA for early detection, monitoring of treatment response, and as a surrogate end point of efficacy for interventions in men with different clinical risk states for the prevention and progression of prostate cancer. Am J Ther 2004, 11:501–506.

    Article  PubMed  Google Scholar 

  8. Oesterling JE, Jacobsen SJ, Chute CG, et al.: Serum prostate-specific antigen in a community-based population of healthy men: establishment of age-specific reference ranges. JAMA 1993, 270:860–864.

    Article  PubMed  CAS  Google Scholar 

  9. Morote J, Lopez M, Encabo G, de Torres IM: Effect of inflammation and benign prostatic enlargement on total and free serum prostate specific antigen. Eur Urol 2000, 37:537–540.

    Article  PubMed  CAS  Google Scholar 

  10. Ornstein DK, Smith DS, Humphrey PA, Catalona WJ: The effect of prostate volume, age, total prostate specific antigen level and acute inflammation on the percent free serum prostate specific antigen levels in men without clinically detectable prostate cancer. J Urol 1998, 159:1234–1237.

    Article  PubMed  CAS  Google Scholar 

  11. National Institute of Health/National Institute of Diabetes and Digestive and Kidney Diseases Workshop on Chronic Prostatitis: National Institutes of Health Summary Statement. Executive Summary. Bethesda, MD; 1995.

  12. Nickel JC, Nyberg LM, Hennenfent M: Research guidelines for chronic prostatitis: consensus report from the first National Institutes of Health International Prostatitis Collaborative Network. Urology 1999, 54:229–233.

    Article  PubMed  CAS  Google Scholar 

  13. True LD, Berger RE, Rothman I, et al.: Prostate histopathology and chronic prostatitis/chronic pelvic pain syndrome: a prospective biopsy study. J Urol 1999, 162:2014–2018.

    Article  PubMed  CAS  Google Scholar 

  14. Carver BS, Bozeman CB, William BJ, Venable DD: The prevalence of men with National Institutes of Health category IV prostatitis and association with serum prostate specific antigen. J Urol 2003, 169:589–591.

    Article  PubMed  CAS  Google Scholar 

  15. Okada K, Kojima M, Naya Y, et al.: Correlation of histological inflammation in needle biopsy specimens with serum prostate-specific antigen levels in men with negative biopsy for prostate cancer. Urology 2000, 55:892–898.

    Article  PubMed  CAS  Google Scholar 

  16. Stancik I, Luftenegger W, Klimpfinger M, et al.: Effect of NIH-IV prostatitis on free and free-to-total PSA. Eur Urol 2004, 46:760–764.

    Article  PubMed  Google Scholar 

  17. Rowe WE, Laniado ME, Walker MM, Anup P: Incidental acute prostatic inflammation is associated with a lower percentage of free prostate-specific antigen than other benign conditions of the prostate: a prospective screening study. BJU Int 2006, 97:1039–1042.

    Article  PubMed  Google Scholar 

  18. Bozeman CB, Carver BS, Eastham JA, Venable DD: Treatment of chronic prostatitis lowers serum prostate specific antigen. J Urol 2002, 167:1723–1726.

    Article  PubMed  Google Scholar 

  19. Potts JM: Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol 2000, 164:1550–1553.

    Article  PubMed  CAS  Google Scholar 

  20. Nadler RB, Collins MM, Propert KJ, et al.: Prostate-specific antigen test in diagnostic evaluation of chronic prostatitis/chronic pelvic pain syndrome. Urology 2006, 67:337–342.

    Article  PubMed  Google Scholar 

  21. Eastham JA, Riedel E, Scardino PT, et al.: Variation of serum prostate-specific antigen levels: an evaluation of year-to-year fluctuations. JAMA 2003, 289:2695–2700.

    Article  PubMed  CAS  Google Scholar 

  22. Ankerst DP, Miyamoto R, Nair PV, et al.: Yearly prostate specific antigen and digital rectal examination fluctuations in a screened population. J Urol 2009, 181:2071–2075.

    Article  PubMed  Google Scholar 

  23. Loeb S, Gashti SN, Catalona WJ: Exclusion of inflammation in the differential diagnosis of an elevated prostate-specific antigen (PSA). Urol Oncol 2009, 27:64–66.

    PubMed  CAS  Google Scholar 

  24. Scardino PT: The responsible use of antibiotics for an elevated PSA level. Nat Clin Pract Urol 2007, 4:1.

    Article  PubMed  Google Scholar 

  25. Rodriquez LV, Terris MK: Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 1998, 160:2115–2020.

    Article  Google Scholar 

  26. Aron M, Rajeev TP, Gupta NP: Antibiotic prophylaxis for transrectal needle biopsy of the prostate: a randomized controlled study. BJU Int 2000, 85:682–685.

    Article  PubMed  CAS  Google Scholar 

  27. Feliciano J, Teper E, Ferrandino M, et al.: The incidence of fluoroquinolone resistant infections after prostate biopsy: are fluoroquinolones still effective prophylaxis? J Urol 2008, 179:952–955.

    Article  PubMed  Google Scholar 

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Correspondence to Jaspreet S. Sandhu.

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Sandhu, J.S. Management of elevated prostate-specific antigen in men with nonbacterial chronic prostatitis. Curr Urol Rep 10, 302–306 (2009). https://doi.org/10.1007/s11934-009-0049-0

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