Altered prostate specific antigen reference range after transurethral resection of the prostate

Objectives: We investigated how transurethral resection of the prostate (TU RP) affected the serum concentration of prostate specific antigen (PSA) and whether the reference range for PSA has to be altered in these patients fo llowing TURP. Methods: 55 patients were retrospectively analysed. All had u ndergone TURP for bladder outlet obstruction due to benign prostatic hyperp lasia which was confirmed by histopathological amination. PSA was determine d pre-operatively and postoperatively every 6 months for 48 months. These p atients were compared to 12 patients who had undergone radical perineal pro statectomy (RPP) for prostate cancer (CaP). In the latter group, in all pat ients a TURP had been performed up to 7 years before CaP was diagnosed. Res ults: The median PSA concentration was 4.9 ng/ml before TURP and was subseq uently reduced to 0.6 ng/ml after 48 months. There was a steady decrease of the PSA concentration during the observation period. In contrast in patien ts who subsequently developed a CaP, the median PSA concentration before TU RP was 6.8 ng/ml and was reduced to only 2.2 ng/ml after 48 months. PSA lev els started to rise before CaP was diagnosed. Conclusion: After a TURP with a benign histopathologic specimer)PSA levels decrease steadily to values b elow 2 ng/ml. In case these patients demonstrate a rising PSA in the follow -up after partial prostatectomy, a CaP should be ruled out.