INCREASED SERUM TOTAL CREATINE-KINASE AND CREATINE-KINASE ISOENZYME MB AFTER CRYOSURGICAL ABLATION OF THE PROSTATE

Purpose: Several reports have documented that the MB isoenzyme of crea tine kinase is present in prostatic tissue. However, since it has been shown that lower urinary tract manipulations, including transurethral prostatectomy, do not significantly increase serum creatine kinase is oenzyme MB levels, such elevations, which are found in patients after prostatic surgery, are believed to be specific for myocardial infarcti on. We examined whether cryosurgical ablation of the prostate altered serum creatine kinase or isoenzyme MB levels. Materials and Methods: I n 81 consecutive patients undergoing routine cryosurgical ablation of the prostate serum levels of creatine kinase and creatine kinase isoen zyme NIB were measured from peripheral blood specimens drawn preoperat ively, in the recovery room and at 8 and 24 hours postoperatively. Pos toperative electrocardiograms were compared to the preoperative study. Results: In 72 of 81 patients (89%) significant elevations in creatin e kinase and creatine kinase isoenzyme MB levels were noted at all tim e points after cryosurgical ablation of the prostate and appeared to r each a peak at 16 hours postoperatively. The mean increases within the first 8 hours after cryosurgical ablation of the prostate were 1,355 units per 1. for creatine kinase and 46.6 ng./ml. for creatine kinase isoenzyme MB. No patient had any significant changes on the postoperat ive electrocardiogram. All 9 patients (11%) who did not have significa nt creatine kinase or creatine kinase isoenzyme MB levels therapy. Con clusions: Cryosurgical ablation of the prostate appears to produce ele vations in serum creatine kinase and creatine kinase isoenzyme MB, whi ch are specific to the procedure. Assays for creatine kinase isoenzyme MB are unreliable to render a diagnosis of myocardial infarction afte r cryosurgical ablation of the prostate.