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

Autor: Mayank Pahwa, Mohit Girotra, Mrinal Pahwa, Archna R. Pahwa, Ajay P. Sharma, Arun Chawla
Rok vydání: 2013
Předmět:
Nephrology
Male
medicine.medical_specialty
Urology
medicine.medical_treatment
Prostatic Hyperplasia
urologic and male genital diseases
Risk Assessment
Severity of Illness Index
Cohort Studies
Prostate
Predictive Value of Tests
Internal medicine
Severity of illness
medicine
Humans
Minimally Invasive Surgical Procedures
Postoperative Period
Prospective Studies
Prospective cohort study
Transurethral resection of the prostate
Aged
Ultrasonography
business.industry
Patient Selection
Urinary bladder neck obstruction
Transurethral Resection of Prostate
Middle Aged
Prostate-Specific Antigen
medicine.disease
Urinary Bladder Neck Obstruction
Prostate-specific antigen
medicine.anatomical_structure
Treatment Outcome
Patient Satisfaction
Predictive value of tests
Preoperative Period
business
Follow-Up Studies
Zdroj: International urology and nephrology. 45(4)
ISSN: 1573-2584
Popis: 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.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.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.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.
Databáze: OpenAIRE
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