Skip to main content

Advertisement

SpringerLink
Log in

Changes in S-PSA after transurethral resection of prostate and its correlation to postoperative outcome

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Purpose

Although different factors may affect prostate-specific antigen (PSA) reduction after transurethral resection of prostate, an approximate 70 % decrease from baseline is expected. We hereby undertook a prospective study to analyze changes in serum PSA (S-PSA) after transurethral resection of the prostate (TURP) and its correlation with the residual prostatic weight and clinical symptom score improvement.

Methods

Seventy patients who underwent TURP for bladder outlet obstruction were included in the study. Patient’s evaluation included history, International Prostate Symptom Score (IPSS), S-PSA, Qmax, post-void residual urine and prostate size. On follow-up, trans-rectal ultrasonography, S-PSA and IPSS score were calculated. Patients were analyzed in three groups based on the amount of tissue resected: less than 40, 40–60 and more than 60 % tissue resected.

Results

Preoperative prostate size, IPSS, Qmax and S-PSA were 62.56 ml, 23.84, 11.68 ml/sec and 3.3 ng/ml. There was a significant decrease in the IPSS score, prostate size and S-PSA levels after TURP in all the three groups. There was a significant positive correlation of the amount of tissue resected with change in S-PSA levels, change in IPSS score and postoperative IPSS score. Reduction in IPSS score significantly correlated with patient’s satisfaction.

Conclusions

The amount of tissue resected in TURP has a direct bearing on the S-PSA levels, change in symptom score and residual prostate volume. It is the percentage change in IPSS score and not the absolute value of IPSS, which has a direct bearing with the patient satisfaction and with the amount of tissue resected. Percentage fall in S-PSA by 70 % was found to be predictor of more than 60 % resection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. AUA Prostate Cancer Clinical Guideline Update Panel (2007) Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol 177(6):2106–2131

    Article  Google Scholar 

  2. Aus G, Bergdahl S, Frosing R, Lodding P, Pileblad E, Hugosson J (1996) Reference range of prostate-specific antigen after transurethral resection of the prostate. Urology 47:529–531

    Article  PubMed  CAS  Google Scholar 

  3. Scattoni V, Raber M, Montorsi F, Da Pozzo L, Brausi M, Calori G et al (1999) Percent of free serum prostate-specific antigen and histological findings in patients undergoing open prostatectomy for benign prostatic hyperplasia. Eur Urol 36:621–630

    Article  PubMed  CAS  Google Scholar 

  4. Speakman MJ (1999) Who should be treated and how? Evidence based medicine in symptomatic BPH. Eur Urol 36(3):21–27

    Google Scholar 

  5. Cetinkaya M, Ulusoy E, Aki T, Koşan M, Kundak C, Aydos MM, Gökkaya S (1999) Effect of transurethral resection on serum free/total prostate-specific antigen levels in patients with benign prostatic hyperplasia. Urology 53(1):118–120

    Article  PubMed  CAS  Google Scholar 

  6. Lloyd SN, Collins GN, McKelvie GB, Hehir M, Rogers AC (1994) Predicted and actual change in serum PSA following prostatectomy for BPH. Urology 43:472–479

    Article  PubMed  CAS  Google Scholar 

  7. Marks LS, Dorey FJ, Rhodes T, Shery ED, Rittenhouse H, Partin AW et al (1996) Serum prostate specific antigen levels after transurethral resection of prostate: a longitudinal characterization in men with benign prostatic hyperplasia. J Urol 156:1035–1039

    Article  PubMed  CAS  Google Scholar 

  8. Kyriakidis A, Georgiadis M, Stiakakis I, Kyriakidis A, Koutselinis A (1996) Prostatic tissue distal to the verumontanum and its significance for adenomatous recurrences after transurethral resection of the prostate. A cadaver study. Eur Urol 29(1):21–25

    PubMed  CAS  Google Scholar 

  9. Recker F, Kwiatkowski MK, Pettersson K, Piironen T, Lummen G, Huber A et al (1998) Enhanced expression of prostate-specific antigen in the transition zone of the prostate. A characterization following prostatectomy for benign hyperplasia. Eur Urol 33:549–555

    Article  PubMed  CAS  Google Scholar 

  10. Vesey SG, Goble NM, Stower MJ, Hammonds JC, Smith PJ (1988) The effects of transurethral prostatectomy on serum prostate specific antigen. Br J Urol 62:347–351

    Article  PubMed  CAS  Google Scholar 

  11. Furuya Y, Akakura K, Tobe T, Ichikawa T, Igarashi T, Ito H (2000) Changes in serum prostate-specific antigen following prostatectomy in patients with benign prostate hyperplasia. Int J Urol 7(12):447–451

    Article  PubMed  CAS  Google Scholar 

  12. Hosseini SY, Salimi M, Hosseini Moghaddam SM (2005) Changes in serum prostate-specific antigen level after prostatectomy in patients with benign prostatic hyperplasia. Urol J 2(4):183–188

    PubMed  Google Scholar 

  13. Choi HS, Kim DJ, Kim DS, Jeon KP, Jeong TY (2011) Factors affecting the improvement of the initial peak urinary flow rate after transurethral resection of the prostate or photoselective vaporization of the prostate for treating benign prostatic hyperplasia. Int Neurourol J 15:35–40

    Article  PubMed  Google Scholar 

  14. Bright E, Pearcy R, Abrams P (2011) Ultrasound estimated bladder weight in men attending the uroflowmetry clinic. Neurourol Urodyn 30(4):583–586

    Article  PubMed  Google Scholar 

  15. Antunes AA, Srougi M, Coelho RF, Leite KR, Freire Gde C (2009) Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign Prostatic hyperplasia: How much should be resected? Int Braz J urol 35(6):683–691

    Article  PubMed  Google Scholar 

  16. Green JS, Bose P, Thomas DP, Thomas K, Clements R, Peeling WB et al (1996) How complete is a transurethral resection of the prostate? Br J Urol 77:398–400

    Article  PubMed  CAS  Google Scholar 

  17. Fonseca RC, Gomes CM, Meireles EB, Freire GC, Srougi M (2008) Prostate specific antigen levels following transurethral resection of the prostate. Int Braz J Urol 34(1):41–48

    Article  PubMed  Google Scholar 

  18. Milonas D (2010) Significance of operative parameters on outcomes after transurethral resection of the prostate. Medicina (Kaunas) 46(1):24–29

    Google Scholar 

  19. Chen SS, Hong JG, Hsiao YJ, Chang LS (2000) The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int 85(1):79–82

    Article  PubMed  CAS  Google Scholar 

  20. Hakenberg OW, Helke C, Manseck A, Wirth MP (2001) Is there a relationship between the amount of tissue removed at transurethral resection of the prostate and clinical improvement in benign prostatic hyperplasia. Eur Urol 39(4):412–417

    Article  PubMed  CAS  Google Scholar 

  21. Agrawal MS, Aron M, Goel R (2005) Hemiresection of the prostate: short-term randomized comparison with standard transurethral resection. J Endourol 19:868–872

    Article  PubMed  Google Scholar 

  22. Stamey TA, Yang N, Hay AR, McNeal JE, Freiha FS, Redwine E (1987) Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 317:909–916

    Article  PubMed  CAS  Google Scholar 

  23. Renterghem KV, Koeveringe GV, Achten R, Kerrebroeck PV (2007) Clinical relevance of transurethral resection of the prostate in ‘‘asymptomatic’’ patients with an elevated prostate-specific antigen level. Eur Urol 52:819–826

    Article  PubMed  Google Scholar 

  24. Sparwasser C, Reihmann M, Knes J et al (1995) Long-term results of transurethral prostate incision (TUIP) and transurethral prostate resection (TURP). A prospective randomized study. Urologe A 34(2):153−157

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Sir Ganga Ram Hospital, New Delhi, India

    Mrinal Pahwa, Mayank Pahwa, Archna R. Pahwa, Mohit Girotra, Arun Chawla & Ajay Sharma

  2. 78-c, Mianwali Colony, Gurgaon, 122001, India

    Mrinal Pahwa

Authors
  1. Mrinal Pahwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mayank Pahwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Archna R. Pahwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohit Girotra
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arun Chawla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ajay Sharma
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mrinal Pahwa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pahwa, M., Pahwa, M., Pahwa, A.R. et al. Changes in S-PSA after transurethral resection of prostate and its correlation to postoperative outcome. Int Urol Nephrol 45, 943–949 (2013). https://doi.org/10.1007/s11255-013-0474-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-013-0474-3

Keywords

Search

Navigation