INFLUENCE OF DIGITAL RECTAL MASSAGE ON URINARY PROSTATE-SPECIFIC ANTIGEN - INTEREST FOR THE DETECTION OF LOCAL RECURRENCE AFTER RADICAL PROSTATECTOMY

BACKGROUND. Following radical prostatectomy, urinary prostate-specific antigen (uPSA) may originate from periurethral glands or from recurre nt carcinomatous prostatic cells. We evaluated massage of the urethro- vesical anastomosis as a uPSA-releasing method for the detection of lo cal recurrence. METHODS. PSA was assessed (PSA IMxTM, Abbott Diagnosti c, Rungis, France) in serum and in the first voided urine before and a fter massage in 59 patients: 7 after cystoprostatectomy for bladder ca ncer, 22 with prostate in situ, and 30 after radical prostatectomy for prostate cancer. RESULTS. No significant changes of uPSA were induced by the massage in cystoprostatectomy patients and in 4 radical prosta tectomy patients with a negative biopsy of the anastomosis. Ln contras t, a significant increase of uPSA was observed after massage in the pa tients with prostate in situ and in 6 radical prostatectomy patients w ith biopsy-proven local relapse. CONCLUSIONS. uPSA before and after ma ssage of the prostatic fossa may constitute a new and efficient tool f or the detection of local recurrence, if these preliminary results are confirmed on a larger scale. (C) 1998 Wiley-Liss, Inc.