PROPOSE: MEASURING SERUM PSA LEVEL AND PROSTATE VOLUME PRIOR TO OPEN PROSTATECTOMY FOR SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA, AND COMPARING THE FORMER WITH POST OPERATIVE VALUES.
METHODS & MATERIALS: SERUM PSA LEVELS WERE DETERMINED IN 47 CONSECUTIVE PATIENTS BEFORE AND 6 TO 24 MONTHS AFTER OPEN PROSTATECTOMY. PROSTATE VOLUME WAS ALSO ESTIMATED PREOPERATIVELY BY SONOGRAPHY. DATA WERE ANALYZED FOR CORRELATION BY PEARSON'S COEFFICIENT.
RESULTS: A SIGNIFICANT DIFFERENCE WAS SEEN BETWEEN PRE AND POST OPERATIVE PSA LEVEL (P<0.0001). THE HIGHER THE INITIAL PSA CONCENTRATION, THE GREATER THE ANTICIPATED CHANGE. INITIAL PROSTATE VOLUME WAS POSITIVELY CORRELATED TO THE PREOPERATIVE PSA LEVEL (P<0.0001). PATIENTS WITH AN INITIAL PSA LEVEL OF ≥4 NG/ML HAD A SIGNIFICANTLY DISCREPANT PSA DENSITY COMPARED TO THOSE WITH SERUM PSA LESS THAN 4 NG/ML. BASED ON THESE RESULTS, A FORMULA WAS DEVELOPED TO PREDICT POST PROSTATECTOMY PSA USING PREOPERATIVE VOLUME AND PSA LEVELS.
DISCUSSION & CONCLUSION: SERM PSA IS ELEVATED ABOVE THE NORMAL CUTOFF OF 4 NG/ML IN TWO THIRDS OF MEN WITH BPH SCHEDULED FOR OPEN PROSTATECTOMY. HOWEVER, PSA RETURNS TO NORMAL IN 95.7% OF SUCH CASES, AND THE MAGNITUDE OF THIS CHANGE CAN BE PREDICTED USING OUR PROPOSED FORMULA WITH 99% CONFIDENCE.