ALLOPURINOL TREATMENT RESULTS IN ELEVATED PROSTATE-SPECIFIC ANTIGEN LEVELS IN PROSTATIC FLUID AND SERUM OF PATIENTS WITH NONBACTERIAL PROSTATITIS

Non-bacterial prostatitis is a common problem in young men. It is a di sease which is often recurrent and each episode lasts for several mont hs. Different causative mechanisms of the disease have been discussed including identified and non-identified microorganisms, stone formatio n and psychological factors. It was shown in an earlier study that uri nary reflux (as shown by a high creatinine concentration in prostatic fluid) took place to a varying extent in the prostatic ducts and this reflux was related to prostatic pain and urate concentration in expres sed prostatic secretion (EPS). Allopurinol treatment lowered the urate concentration irt EPS and relieved the subjective discomfort. This st udy reports serum (S) levels of prostate-specific antigen (PSA) in pat ients with non-bacterial prostatitis and the way in which S-PSA was af fected by allopurinol treatment. It is also shown that the S-PSA level is age dependent. A correlation existed between the S-PSA concentrati on and EPS content of white blood cells. Patients with high EPS urate concentrations corresponded to low S-PSA levels and allopurinol treatm ent resulted in elevated S-PSA levels. PSA in EPS was also increased b y allopurinol treatment. Hence, an increased release of PSA from the p rostate gland was noted upon allopurinol treatment. The mechanism of t he allopurinol-induced release is obscure. It might be explained by an induction of PSA synthesis via an allopurinol effect on the genome bu t an increased leakage of the prostatic cells elicited by allopurinol could no be ruled out.