Effects of prostatectomy in patients with elevated serum prostate specific antigen levels and lower urinary tract symptoms: A prospective study

Our aim is to determine the impact of prostatectomy on serum prostate specific antigen levels in patients with Lower Urinary Tract symptoms (LUTS), but negative multicore prostate biopsy results and higher serum prostate specific antigen levels. 100 patients were referred to our clinics with lower urinary system symptoms without any evidence of suspect prostate carcinoma in digital rectal examination, and transurethral ultrasound (TRUS). Patients with histopathologically benign diagnoses in prostatic biopsy because of higher serum prostate specific antigen (PSA) levels (PSA>4ng/ml) were retrospectively evaluated. The association between preoperative and postoperative 3 and 6 month serum PSA levels were statistically evaluated in patients who had undergone transurethral resection of the prostate (TUR-P) or open prostatectomy resection with the diagnosis of benign prostatic hyperplasia (BPH), and also correlation between changes in serum PSA levels and histopathologic diagnosis was analysed. The preoperative mean total PSA (tPSA) and free PSA (fPSA) values were 16.89 ng/mL and 3.65ng/mL, respectively. Postoperative 3 month- mean tPSA and fPSA values were 1.34 and 0.4ng/mL, while postoperative 6 month mean tPSA and fPSA values were determined as 1.59 and 0.56ng/mL, respectively. Postoperative histopathologic evaluation of the surgical specimens of the patients revealed BPH in 84%, BPH + prostatitis in 12%, and prostate cancer 4% of the cases, respectively. BPH surgery can be performed safely on patients with symptomatic BPH and increased PSA levels without any evidence of prostate carcinoma. Favourable and comforting results can be achieved with BPH surgery, which improves symptoms and normalises PSA values.