Prostat Spesifik Antijenin Akut Üriner Retansiyon Sonrası Üretral Kateter Yerleştirilen ve Benign Prostat Hiperplazisi Olan Hastalarda Prostat Adenokarsinomu Saptamadaki Rolü

Abstract

Amaç: Akut idrar retansiyonu (AİR) benign prostat hiperplazisi (BPH) hastalarında en önemli komplikasyonlardan biridir ve tedavisi genellikle akut dönemde üretral kateterizasyondur. AİR ve üretral kateter yerleştirilmesinin serum PSA seviyelerinde bir artışa neden olabileceğini gösteren çalışmalar vardır. Bu çalışmada amacımız, AİR sonrası üretral kateter yerleştirilen hasta grubunda artmış PSA düzeyleri ile prostat kanseri (PCa) insidansı arasındaki ilişkiyi araştırmaktır.

Gereç ve Yöntemler: AUR nedeniyle kalıcı bir üretral kateteri olan 77 hastada, yüksek PSA seviyeleri nedeniyle yapılan prostat biyopsileri ve daha sonra klinik BPH için yapılan cerrahi tedaviler retrospektif olarak incelendi. Hastaların yaş, prostat hacimleri, biyopsi öncesi total serum PSA ve PSA dansiteleri kaydedildi. Biyopsi veya cerrahi örnek sonuçlarına göre total PSA oranları, PSA dansiteleri ve prostat hacimleri PCa’nın saptandığı (n = 6) ve saptanmadığı (n = 71) gruplar için karşılaştırıldı.

Bulgular: Hastaların yaş ortalaması 65.2 ± 3.9 idi. Ortalama prostat hacmi 64.1 ± 12.8 g, ortalama serum total PSA seviyesi 9.2 ± 4.2 ng / mL ve ortalama serum PSA dansitesi 0.15 ± 0.08 mg / mL / g olarak ölçülmüştür. Serum total PSA düzeyi ≤4.0, 4-10, 10-20 ve >20 olan PSA gruplarında PCa prevalansı sırasıyla % 0, % 4,3, % 13,4 ve % 20 olarak tespit edildi. Toplam PSA düzeyleri ve PSA dansiteleri, PCa tespit edilen grupta istatistiksel olarak daha yüksek bulundu.

Sonuç: AİR sonrası üretral kateter yerleştirilen hastalarda PCa insidansı düşüktür. Bu hastalar için prostat biyopsisi sadece seçilmiş vakalarda yapılmalıdır.

Keywords

• acute urinary retention
• biopsy
• prostate cancer

Role of Prostate Specific Antijen in Prostatic Adenocarcinoma Detection in Patients with Benign Prostate Hyperplasia and Were Placed Urethral Catheter After Acute Urinary Retention

Abstract

Objective: Acute urinary retension (AUR) is one of the most important complications in benign prostate hyperplasia (BPH) patients and its treatment is generally urethral catheterization in acute period. There are studies showing that AUR and urethral catheter placement may cause an increase in serum PSA levels. Our objective in this study was to investigate the relation between increased PSA levels and prostate cancer (PCa) incidence in the patient group after AUR and urethral catheter placement.

Materials and Methods: 77 patients who had an indwelling urethral catheter due to AUR, performed prostate biopsy due to high PSA levels and then surgical treatment for clinic BPH were retrospectively examined. Age, prostate volumes, pre-biopsy total serum PSA and PSA densities were noted. Total serum PSA rates, PSA densities and prostate volumes were compared for the groups that PCa was detected (n=6) and not detected (n=71) according to biopsy or surgical specimen results.

Results: Mean age of the patients was 65.2±3.9 years. Mean prostate volume was measured as 64.1±12.8 g, mean serum total PSA level as 9.2±4.2 ng/mL and mean serum PSA density as 0.15±0.08 mg/mL/g. In PSA groups with a serum total PSA level of ≤4.0, 4-10, 10-20 and >20, PCa prevalence rates were detected 0%, 4.3%, 13.4% and 20%, respectively. Total PSA levels and PSA densities were found statistically higher in PCa detected group.

Conclusion: PCa incidence is low in patients who were placed urethral catheter after AUR. For these patients prostate biopsy should be performed only in chosen cases.

Keywords

• acute urinary retention
• biopsy
• prostate cancer

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