Prostate specific antigen and prostatitis I. Effect of prostatitis on serum psa in the human and nonhuman primate

Abstract

Prostate specific antigen (PSA) has become a mainstay in the diagnosis and management of patients with prostate cancer. We have found, as have others, that it may be elevated in patients with prostatic inflammation. Ten patients had clinical evidence of prostatitis and elevated PSA levels. Six of these had persistently elevated levels after antibiotic treatment. After transrectal ultrasonography and biopsy, two had findings of adenocarcinoma, and the rest had a pathologic diagnosis of acute or chronic prostatitis. We studied this process in an experimental model of prostatitis using a nonhuman primate. We infected six cynomolgus monkeys and followed their PSA levels until resolution of the infection. The PSA peaked between 5 and 7 days after inoculation and gradually returned to baseline in 8 weeks. The dramatically elevated serum PSA levels in bacterial prostatitis can cause confusion in the diagnosis of prostatic carcinoma.

Seminal plasma PSA in spinal cord injured men: a preliminary report

“…The observed di erence found in seminal plasma PSA concentration, however, is unlikely to be explained by storage, as the handling of samples were identical in the two groups. Serum PSA concentration increases in patients with urinary retention, lower urinary tract infections, and prostatitis, 22,23 conditions frequently present in patients with SCI. The impact of these conditions on seminal plasma PSA has not been elucidated.…”

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

“…4,5,12 However, many studies have shown that inflammation is a factor that must be considered in prostate cancer screening studies, as it increases PSA values. 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.…”

“…3 Acute prostatitis is one of the well-established causes of PSA elevation. 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.…”

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

“…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.…”