CLINICAL IMPLICATIONS OF THE RISE AND FALL OF PROSTATE-SPECIFIC ANTIGEN AFTER LASER PROSTATECTOMY

Objective To characterize the serum kinetics of prostate specific anti gen (PSA) after visual laser ablation of the prostate (VLAP). Patients and methods The PSA values of 45 patients were measured at 24 h and a t 1, 4, 12, 26 and 52 weeks after VLAP and the changes assessed in rel ation to symptom scores, urinary now rates and prostate size. Results After an initial rise immediately after VLAP, the serum PSA level decl ined. At 24 h, the PSA value reached a mean level 23 times higher than the PSA level before VLAP and then took a mean of 78 days to reach a new baseline. The mean decrease of the subsequent baseline value relat ive to that before treatment was 1.7 ng/mL. The prostatic size and ene rgy applied correlated positively with the rise in PSA 24 h after VLAP . The rise in maximal urinary now after VLAP, the decrease in the symp tom score and residual urine volume did not correlate with the rise in PSA level 24 h after VLAP or with the time to reach a value halfway b etween the level at 24 h and the new baseline value. Conclusions The p attern of the increase in serum PSA level and decline after VLAP was n ot predictive of the clinical outcome of therapy.