Prostate-specific antigen and prostate volume in Korean men with spinal cord injury: a case–control study

Abstract

Study design: Prospective, cross-sectional, case-control study. Setting: Outpatient department in Seoul, Korea. Objectives: To assess prostate volume and serum prostate-specific antigen (PSA) levels in Korean men with spinal cord injury (SCI). Methods: A total of 31 SCI patients with ages ranging between 45 and 81 years old (median age, 58 years) were studied. Thirty-one age-matched individuals without SCI were enrolled in the study as controls. We tested PSA levels and performed transrectal ultrasonographies on all enrolled patients. Of the patients with SCI, 20 were evaluated for testosterone, luteinizing hormone (LH), and folliclestimulating hormone (FSH) levels. Results: Serum PSA levels and prostate volume parameters in the two groups had similar values: the median (5th-95th percentiles) serum PSA level was 1.56 ng/ml (0.12-9.77) for SCI patients and 1.04 ng/ml (0.50-2.98) for controls (P ¼ 0.481), whereas the median (5th-95th percentiles) prostate volume was 18.33 ml (10.16-76.78) for SCI patients and 20.80 ml (14.23-41.22) for controls (P ¼ 0.072). No significant differences were found when serum PSA levels and prostate volumes were compared according to SCI patient injury characteristics. Testosterone levels were lower than the normal range in 7 SCI patients (35%), LH was higher than the normal range in 10 SCI patients (20%), and FSH was higher than the normal range in eight SCI patients (40%). We observed an age-related increase in FSH levels (r ¼ 0.634, P ¼ 0.004), although hormone levels did not correlate with serum PSA levels and prostate volume parameters. Conclusions: According to our results, serum PSA levels and prostate volume in Korean SCI patients are not different from those in uninjured men and are not affected by injury characteristics.

Prostate volume in male patients with spinal cord injury: a question of nerves?

“…Whereas Shim et al. , in their study of 31 men with SCI, and Pannek et al. in 100 men , could not detect significant differences in prostate size and PSA values between men with SCI and men without SCI, Frisbie et al.…”

“…Hormonal factors are known to cause prostatic enlargement , and experiments in rats with SCI indicate that neurogenic factors also play an important role in prostate growth and function . To assess the influence of autonomic denervation on prostate growth in humans, the impact of SCI on prostate size has been studied; however, these studies have provided conflicting results, partly because of the limited size of the study populations, but also because they have included men with different severity of SCI .…”

Effects of stress on male voiding function

“…Men suffering from complete spinal cord injury were noted to have signifi cantly smaller prostates than age-matched controls [32], although some authors have noted no difference between men suffering from spinal cord injury and controls [16,33]. It has been suggested that this disparity in fi ndings may be because of the severity of the lesions reported in the studies [34].…”

“…Less severely injured patients without paralysis were noted to have signifi cantly larger prostate volumes by transrectal ultrasound [32]. Taking into consideration the alterations expected in the hypothalamic-pituitary axis after spinal cord injury, prostate-specifi c antigen (PSA) was also investigated, and some slight-but not statistically signifi cant-differences were noted by some investigators [32,33]. This subset of patients nonetheless affords us an interesting opportunity to study prostate size and growth and the incidence of prostate cancer in the absence of autonomic innervation and thus deserves further investigation.…”

An evidence-based review of aging of the body systems following spinal cord injury

“…84 It was shown that those individuals with SCI under 20 years of age or older than 50 had comparable renal functioning to the AB controls, whereas persons between those ages were more likely to have impaired functioning. Finally, there is level 5 evidence that men with SCI do not appear to be at higher risk for the development of prostate cancer compared with the general population, [85][86][87][88][89][90] but when detected in persons with SCI (n ¼ 7), the cancer may be more advanced and metastatic than in AB controls (N ¼ 267) (Scott et al…”