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

ABSTRACT

The level of PSA in serum is increased by inflammation of the prostate, urinary retention,prostatic infection, benign prostatic hyperplasia,prostate cancer, and prostatic manipulation. [3] To study the effect of acute urinary retention on the serum prostate-specific antigen [PSA] concentration. 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. Fourty-two patients with a mean age of 70.18 years [range 56 to 85 years] participated in this study.mean PSA level at the time of AUR [PSA1] was 7.02 ng/mL [median, 5.8 ng/mL; range, 0.9 to 30.4 ng/mL]. The mean PSA2 level was 5.5 ng/mL [median, 3.9 ng/mL; range, 0.7 to 39 ng/mL], lower than the PSA1 level.This association was statistically non significant P>0.05. The mean prostate volume at the time of DRE1 [43.4 mL; median, 45 mL; range, 30 to 60 mL] was significantly higher than at DRE2 [37.8 mL; median, 40 mL; range, 25 to 50 mL] [P<0.001]. PSA3 was measured in 42 patients 4 weeks after retention [2 weeks after catheter removal]. In this group of patients, mean PSA2 and PSA3 levels were 5.5 ng/mL and 5.1 ng/mL, respectively [median, 3.9 and 3.5, respectively, P>0.05]. Acute urinary retention can increase serum PSA levels. In this series, we found that this effect may continue up to 2 weeks