Inflammation in Benign Prostatic Hyperplasia: Correlation With Prostate Specific Antigen Value

Irani, Jacques; Levillain, P.; Goujon, Jean-Michel; Bon, D.; Doré, B.; Aubert, Jacques

doi:10.1016/s0022-5347(01)64957-7

Cited by 174 publications

(150 citation statements)

References 9 publications

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“…Some of these studies found that tPSA levels were significantly higher in patients with prostatitis; however, others failed to support that conclusion, stating that there was no significant association between the existence of prostatitis and tPSA levels, age and prostatic volume. [19][20][21][22][23] In the present study, neither prostatic pathology and tPSA nor age and tPSA were found to be related.…”

Section: Discussioncontrasting

confidence: 83%

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

Demirel¹,

Gökkaya²,

Özden³

et al. 2012

Turkish Journal of Urology

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ÖZETAmaç: Akut üriner retansiyonun (AUR) ensık sebebi benign prostat hiperplazisidir(BPH). AUR'un etyolojisini ayrıntılı bir şekilde araştırmak için, BPH'lı hastalarda AUR ve histolojik prostatik inflamasyon ilişkisini değerlendirdik. Gereç ve Yöntem:Çalışmaya Ocak-Aralık 2008 tarihleri arasında BPH'ne bağlı AUR veya alt üriner sistem semptomları (AÜSS) nedeniyle trans üretral rezeksiyon-prostat (TURP) yapılan 226 hasta dahil edildi. Hastalar AUR(+) (n=89) ve AUR(-) (n=137) olmak üzere 2 gruba ayrıldı. Bu iki grup; yaşlarına, rezeke edilen prostat dokusu ağırlığına (Rt), total prostat spesifik antijen (tPSA) düzeylerine ve prostat dokusu patolojisinde inflamasyon varlığına göre karşılaştırıldı. AUR için bağımsız risk faktörleri lojistik regresyon analizi ile değerlendirildi ve P değeri <0.005 ise anlamlı olarak kabul edildi. Bulgular: Bu 226 hastanın ortalama yaşları 67.7±7.7 yıl, ortalama tPSA değeri 6.45±4.97 ng/ml, ortalama rezeke edilen prostat ağırlığı (Rt) 25.47±21.77 gr. idi. Ortalama yaş ve ortalama Rt, AUR(+) grubunda diğer gruba göre anlamlı olarak daha fazla idi (p<0.0001 ve p= 0.031). Prostatik inflamasyonu olan hastalarda AUR gelişme riski olmayanlara göre anlamlı olarak daha yüksek bulundu (p= 0.049). Yapılan lojistik regresyon analizinde, 70 yaşın üzerinde, 25 gr'dan fazla doku çıkarılması ve prostatik inflamasyon varlığı AUR gelişiminde bağımsız risk faktörleri olarak bulundu.Sonuç: Sonuçlarımız göstermektedir ki; BPH'li hastalarda 70 yaşın üzerinde olmak, 25 gr'dan fazla doku çıkarılması ve prostatik inflamasyon varlığı AUR gelişiminde bağımsız risk faktörleridir.Anahtar sözcükler: Akut üriner retansiyon; benign prostat hiperplazisi; alt üriner sistem semptomları; prostat spesifik antijen. ABSTRACT Objective:The most common cause of obstructive acute urinary retention (AUR) is benign prostatic hyperplasia (BPH). To investigate the etiology of AUR, we evaluated the relationship between AUR and histological prostatic inflammation in patients with BPH. Materials and Methods:Between January and December of 2008, 226 patients who underwent transurethral resection of prostate (TURP) for AUR or lower urinary tract symptoms (LUTS) as a result of BPH were included in the study. Patients were classified into AUR(+) (n=89) and AUR(-) (n=137) groups. The two groups were compared along the following dimensions: age, weight of resected prostatic tissue (Rt), total prostate specific antigen (tPSA) levels and the presence of inflammation in the prostatic pathology. Independent risk factors for AUR were evaluated using logistic regression analysis. P values <0.05 were considered significant. Results:The mean age of the 226 patients was 67.7±7.7 years; the mean tPSA level was 6.45±4.97 ng/ml; and the mean weight of resected prostatic tissue (Rt) was 25.47±21.77 g. The mean age and Rt of the AUR(+) group were significantly higher than those of the AUR(-) group (p<0.0001 and p= 0.031, respectively). The odds of AUR were significantly higher in the patients with inflammation than in those without (p= 0.049). An age ...

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Section: Discussioncontrasting

confidence: 83%

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

Demirel¹,

Gökkaya²,

Özden³

et al. 2012

Turkish Journal of Urology

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“…5,6,10,13 In 1995, Nadler et al 5 found in their series, in which they compared 147 patients without clinical prostatitis and with high PSA values to 64 patients with normal PSA values, that acute and chronic prostatitis was related to the increase in PSA. In 1997, Irani et al 7 separately classified the spreading level and aggressiveness of prostatic inflammation, and stated that PSA increase was affected not by the grade of inflammation extent, but that it was affected by the aggressiveness indicating the level of impairment in the epithelial structure. There are many studies in the literature that support and do not support this finding.…”

Section: Commentmentioning

confidence: 99%

“…4 Moreover, in many of the biopsybased studies, it has been reported that prostate inflammation is related to elevated PSA. [5][6][7] In addition, it has been shown that biopsy can be avoided following antibiotics therapy in many patients in whom inflammation was found in the prostatic secretion in the PSA gray zone. [8][9][10] However, treatment of chronic prostatitis diagnosed with the determination of inflammation in the prostatic secretion results in taking direct biopsies in almost half of the patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of antibacterial therapy on PSA change in the presence and absence of prostatic inflammation in patients with PSA levels between 4 and 10 ng/ml

Kaygısız

Uğurlu

Kosan

et al. 2006

Prostate Cancer Prostatic Dis

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We investigated the effect of prostatic inflammation on prostate-specific antigen (PSA) and per cent-free PSA levels changing after antibacterial therapy. We evaluated 48 patients whose PSA levels were between 4 and 10 ng/ml, without any suspicious findings on digital rectal examination, with no infection findings in urine analysis. Prostatic inflammation was assessed with prostatic massage. All the patients were given antibiotic therapy for 3 weeks. Patients were re-evaluated 3 weeks after antibacterial therapy with PSA (free/total) and urinalysis. Ten core biopsies were taken with transrectal ultrasound. No differences were found in terms of age, pre-and post-treatment PSA, and PSA varying between patients with and without inflammation in the prostatic massage. In 18 patients, PSA decreased below 4 ng/ml. Prostate cancer was found in 10.8% of the patients with PSA between 4 and 10 ng/ml and none of the patients with PSA values below 4 ng/ml. We suggest an antibiotic therapy for 3 weeks without regarding inflammation findings when PSA is in the gray zone, for biopsy decision.

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“…1 Many experimental and clinical studies suggest a correlation between acute and chronic prostatitis and increased serum PSA levels. [2][3][4][5][6] Subclinical inflammation of the prostate could elevate serum PSA in asymptomatic patients without clinically detectable prostate cancer. Gerstenbluth et al, 7 in 2002, reported chronic prostatitis as a common finding in radical prostatectomy specimens.…”

Section: Introductionmentioning

confidence: 99%

PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients

Serretta

Catanese

Daricello

et al. 2007

Prostate Cancer Prostatic Dis

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Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P ¼ 0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.

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Inflammation in Benign Prostatic Hyperplasia: Correlation With Prostate Specific Antigen Value

Cited by 174 publications

References 9 publications

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

The risk factors for acute urinary retention in patients with benign prostatic hyperplasia

Effects of antibacterial therapy on PSA change in the presence and absence of prostatic inflammation in patients with PSA levels between 4 and 10 ng/ml

PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients

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