Patients with Elevated Serum PSA and Indwelling Catheter after Acute Urinary Retention: Prospective Study of 63 Patients with 7-Year Follow-Up

Abstract

The detection rate of clinically significant cancer on preoperative biopsies postoperative pathologic exam in patients with AUR and indwelling catheter is low. These patients could be safely operated on without any delay. However, in order to detect clinically important cancer in the peripheral zone a postoperative monitoring period of should be recommended: starting 6 months after operation and continuing subsequently for at least 4 years. Postoperative PSA level is the strongest predictor of cancer detection and could be usefully employed in these patients. AUR and in the patients with large prostate cause elevated PSA. Cancer detection rate on preoperative biopsies is low in these patients. Long postoperative monitoring period should be strongly recommended.

Serum prostate-specific antigen as a predictor of prostate volume in Sudanese patients with benign prostatic hyperplasia

“…Additionally, DRE is simple to perform and practical for estimating the PV, but it has been revealed that DRE underestimates the real prostate size. Rosenberg first assessed the PSA threshold as a predictor of PV by characterizing the relationship between PV and serum PSA in men with symptomatic BPH in the Proscar Long-Term Efficacy and Safety study (Kravchick et al 2007). Because PV is strongly related to serum PSA in men with no evidence of prostate cancer, they suggested that serum PSA can be used to estimate the degree of prostate enlargement accurately enough for it was a useful tool in therapeutic decision making.…”

The effect of urethral catheterization on the level of prostate-specific antigen

“…In one study, it is proposed that TRUS biopsy would not be necessary in patients with indwelling urethral catheters if serum PSA is <10 and prostate volume is more than 60 ml. [78]…”

PSA levels in men with spinal cord injury and under intermittent catheterization

“…Batislam et al1 reported their experience with 90 patients and noted that the presence of the indwelling catheter after UAR may result in maintained elevation of PSA levels. Recently, Kravchick et al3 described 63 patients with AUR and indwelling catheter and noted that mean PSA before catheter insertion differed significantly from PSA obtained on the 5th day after AUR ( P = 0.001). According to the authors, disruption of normal prostatic tissue architecture during AUR allows PSA to diffuse into the prostatic tissue and gain access to the circulation, while inflammatory tissue response caused by urethral catheter maintains elevated PSA.…”

“…PSA is an organ (prostate)‐specific marker, and its level can be increased in various situations such as following urologic manipulations. The relationship between indwelling urethral catheter in patients with acute urinary retention (AUR) and elevated serum PSA values has been already described 1–3. Batislam et al1 compared 45 patients using indwelling catheter with 45 noncatheterized patients submitted to prostatectomy for benign disease and found a direct relationship between indwelling urethral catheter and elevated serum PSA value.…”

“…PSA levels were 2.6 times greater in the first group, possibly as a result of mechanical stimulus from the presence of the catheter itself. An indwelling catheter increases serum PSA levels in a sustainable way after 5 days of catheterization in patients with AUR and a PSA assessment should them be postponed for 2 weeks after these situations 2, 3. Patients with an indwelling urinary catheter inserted electively have not established the effect on serum PSA levels 4…”