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Do_the_Prostatic_Calculi_Cause_High_Level_of_Prostate-_Specific_Antigen.pdf | 3.48 MB |
Introduction and
objective: The benign elevation of prostate specific Antigen (PSA) forms a clinician's dilemma in Middle Eastern men. we Investigated whether the prostatic calculi might influence serum PSA level.
Material and Methods: Between July 2004 and March 2005, 110 patients who underwent sextant core transrectal ultrasound (TRUS) guided prostate biopsy and diagnosed as benign prostatic hyperplasia (BPH) were included. PSA serum level determination, ORE, prostate volume measurements and prostatic calculi detection by TRUS were done for all patients. All patients were biopsied either due to PSA - 4 ng/ml and/or abnormal findings of digital rectal examination (ORE), The patients were divided according to their PSA values into three groups, PSA - 20 ng/ml, PSA 10-20 ng/ml and PSA < lOng /ml, respectively and evaluated separately .
Results: Prostatic calculi were detected in 61 of 110 patients (55.4%). There was no significant association between the presence of prostate calculi and PSA serum level (p = 0.3). Similarly, the association was insignificant between the prostatic calculi and prostate volume (p = 0.6). Abnormal findings of ORE were found in 52 out of 110 patients and these findings were insignificantly associated with the presence of prostatic calculi (p = 0.9). The heterogeneous echo-pattern findings at TRUS were found
in 70 patients (63.6%) and there was positive correlation between the findings
of TRUS and the presence of the prostatic
calculi (p = 0.02). The prostatic calculi were
detected in 31 patients (60.1%) with PSA < 10 ng/ml and in 8 patients (42.1%) with PSA ~ 20 ng/ml. There was no correlation between TPSA serum values and total or
transition volume of prostate (r = 0.05, r = 0.02).
Conclusion: Our study suggests that the presence of prostatic calculi does
not influence the serum PSA level nor the prostate volume. There was no
correlation between total PSA and total and transition zone volume of the
prostate. However, additional prospective studies including histological findings
should be carried out to confirm these results. It must 'be recognized that our results are related
to a specific group of men and patients in another community practice setting
may behave somewhat
differently.