Transvezikal prostatektomi ve transüretral prostatektomi uygulanan hastalarda çıkarılan doku miktarı ile PSA düşüşü arasındaki ilişki

Yıl 2015, Cilt: 4 Sayı: 1, 1 - 4, 01.03.2015

Emre Can Polat Levent Ozcan Alper Otunctemur Emin Ozbek Şinasi Yavuz Önol

Öz

Amaç: Transvezikal prostatektomi (TVP) ve transuretral
prostatektomi (TURP)’ de çıkartılan doku miktarlarıyla PSA
düzeylerindeki düşüş arasındaki ilişkinin incelenmeyi
amaçladık .
Gereç ve yöntem: Patoloji sonuçları adenomyomatoz
hiperplazi gelen TVP yapılan 79 hasta ve TUR-P yapılan 135
hasta çalışmaya dahil edildi. Hastaların ortalama yaşı TVP
grubunda 68.2, TURP grubunda 65.7 idi. Tüm hastalara
operasyon öncesi PRM, serumda total ve serbest PSA, TRUS,
üroflovmetre ve IPSS yapıldı. Postoperatif 3. ayda PSA tekrar
ölçüldü ve total ve serbest PSA değerlerindeki azalma ile
rezeke edilen doku miktarı arasındaki korelasyon araştırıldı.
Bulgular: TVP de prostat dokusunun % 81.4’ ü çıkarılarak
total PSA da % 79, serbest PSA da %58 düşüş saptanırken;
TURP grubunda prostat dokusunun %52’ si çıkarılarak total
PSA da %47, serbest PSA da %42’lik bir düşüş izlenmiştir
(p<0.001). Rezeke edilen 1 gr prostat kütlesine karşılık TVP
grubunda total PSA’ da 0.145 ng/ml, serbest PSA’ da 0.03
ng/ml azalma; TURP grubunda total PSA’ da 0.103 ng/ml,
serbest PSA’ da 0.013 ng/ml azalma bulundu.
Sonuç: BPH nedeniyle TURP yapılan hastalarda, çıkartılan
doku miktarına paralel olarak total ve serbest PSA
değerlerinde azalma olur

Anahtar Kelimeler

Benign prostat hiperplazisi, prostat spesifik antijen, transüretral prostat rezeksiyon, transvezikal prostatektomi

Correlation between the amount of extracted tissue and PSA levels patients treated with transurethral resection of the prostate and transvezical prostatectomy

Öz

OBJECTIVE: To investigate the correlation between extracted
tissue amount and prostate specific antigen (PSA) decline in
patients treated with transvesical prostatectomy (TVP) and
transurethral resection of prostate (TURP).
METHODS: A total of 79 patients who underwent TVP and 135
patients who underwent TUR-P with histopathologically,
diagnosis of BPH was confirmed were enrolled to the study. The
mean age of patients was 68.2 years in TVP group and 65.7
years in TURP group. All patients had DRE, serum total and free
PSA, TRUS, uroflowmeter, and IPSS before the operation. In the
postoperative 3rd month, the PSA measurement was repeated,
and the correlation between the decrease in total and free PSA
levels and the amount of tissue resected during the procedure
was investigated.
RESULTS: In TVP group mean enucleated prostate volume was
81.4%. The decrease in total and free PSA levels was 79% and
58%, respectively. In TURP group mean resected prostate
volume was 52%. The decrease in total and free PSA levels was
47% and 42%, respectively (p<0.001). For 1 g of prostate mass
enucleated in TVP group, the total and free PSA levels
decreased 0.145 ng/ml and 0.03 ng/ml, respectively. In TURP
group for 1 g of prostate mass resected, the total and free PSA
levels decreased 0.103 ng/ml and 0.013 ng/ml, respectively.
CONCLUSION: Total-free PSA levels decrease with the amount
of tissue extracted during TURP in BPH patients.

Anahtar Kelimeler

Benign prostatic hiperplasia, prostate specific antigen, transurethral resection of prostate, transvesical prostatectomy