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[Comparison in the follow-up of two patients with persistent elevated PSA and negative prostate biopsy]
Alessandro Sciarra1, Valeria Panebianco
1Dipartimento di Urologia, Universita' Sapienza di Roma, Roma - Italy.
Purpose:
To compare two clinical cases on the follow-up of patients with benign prostatic hyperplasia at risck of progression, negative prostate biopsy and persistent elevated PSA levels.
Materials:
After a first negative prostate biopsy for elevated PSA levels, Case A received dutasteride therapy for benign prostatic hyperplasia, whereas Case B continued his therapy without dutasteride. In both cases, other diagnostic procedures or other biopsies were decided on the basis of PSA level modifications.
Results:
Case A showed a stabilization of PSA levels with a new nadir; the patient did not undergo new biopsies or other diagnostic procedures till the presence (24 months of follow-up) of a PSA elevation despite dutasteride therapy. A new biopsy, then, showed a prostate adenocarcinoma. Case B showed persistent and progressive PSA elevation; the patient underwent other diagnostic procedures and 2 new negative biopsies. Only after 26 months of follow-up a further biopsy showed a prostate adenocarcinoma.
Conclusions:
5-alpha-reductase inhibitors can reduce the number of unnecessary prostate biopsies.
