Changes of serum prostate-specific antigen following high energy thick loop prostatectomy

Abstract

We evaluated the effect of the high electrocuting energy used with thethick loop, in transurethral vaporization resection of the prostate (TUVRP),on serum prostate-specific antigen (PSA). Forty-eight patients with benignprotatic hyperplasia (BPH) were included in this prospective single armsequential study. All patients had TUVRP using the `Wing' thick resectionelectrode (Richard Wolf, Germany). Serum PSA was measured before, 1 dayand 6 weeks in the morning post TUVRP. PSA values were correlated topreoperative prostate size and to prostatic resection weight. Serum PSAvalues (mean ± SD) were 6.29 ± 4.4 ng/ml, 14.9 ± 11.1 and 2.3 ± 1.9 before, 1 day and 6 weeks post TUVRP respectively. The mean increase in the PSA at 1 day over baseline value was 2.72, this wasstatistically significant (p ≤ 0.0001). The PSA level returned toless than pre TUVRP value in all but 3 patients by 6 weeks. The PSA value1 day post TUVRP correlated well with the pre PSA level, prostate size andprostatic resection weight (r = 0.58, r = 0.38 and r = 0.44 respectively) however, the PSA level at 6 weeks correlated only to pre TUVRP values (r = 0.53). We conclude that that serum PSA is not reliable within 6 weeks of TUVRP. The reversible increase in serum PSA value is similar to other forms of prostatectomy which, suggests that the increased level of electrosurgical energy that is used in TUVRP does not have an added adverse effect on the PSA levels.