effect of acute urinary retention on serum prostate-specific antigen level

Our aim was to evaluate the effect of acute urinary retention on serum prostate-specific antigen [PSA] level. Men aged 50 years and older who presented with acute urinary retention were studied. Patients with urethral stricture, neurogenic bladder, prostate cancer, and those with a history of recent instrumentation or prostate biopsy were excluded. Blood samples for serum PSA measurement were obtained [PSA1], and an indwelling urethral catheter was inserted for 2 weeks. Before catheter removal, a second blood sample for measurement of serum PSA level [PSA2] was obtained. In patients who were able to void, a third sample was obtained 3 weeks later [PSA3]. In the first and second visits, digital rectal examinations [DRE1, DRE2] were performed to assess prostate volume. Mean PSA levels [PSA1, PSA2, and PSA3] and prostate volumes [DRE1, DRE2] were compared. Forty-five patients with a mean age of 70.18 years [range 56 to 85 years] participated in this study. Mean PSA1 and PSA2 levels were 9.8 ng/mL and 5.05 ng/mL, respectively [P<0.001; medians, 6.2 and 4.2 ng/mL]. Mean prostate volumes at the time of retention and 2 weeks later were 43.4 mL and 37.8 mL, respectively [P<0.001; medians, 45 and 40 mL]. PSA3 was measured in 31 patients 2 weeks after catheter removal. In this group of patients, mean PSA2 and PSA3 levels were 5.03 ng/mL and 4.97 ng/mL, respectively [P=0.49; medians, 4.3 and 4.1 ng/mL]. Acute urinary retention can increase serum PSA levels by approximately 2 fold. In this series, we found that this effect may continue up to 2 weeks