Effects of ejaculation on serum prostate-specific antigen levels.

Area of Science:

• Urology
• Andrology
• Biochemistry

Background:

• Prostate-specific antigen (PSA) is a key biomarker for prostate health.
• Elevated PSA levels can indicate benign prostatic hyperplasia (BPH) or prostate cancer, necessitating further investigation like biopsies.
• The influence of ejaculation on PSA levels requires careful consideration in clinical practice.

Purpose of the Study:

• To investigate the impact of ejaculation on serum total, free, and complexed PSA levels.
• To assess how ejaculation-induced PSA changes affect prostate biopsy decisions.

Main Methods:

• A study involving 47 men over 45 with symptomatic BPH and PSA < 2.5 ng/mL.
• PSA levels were measured at baseline after 3 days of abstinence, and then at 1, 5, 24, and 72 hours post-ejaculation.
• A control group of 8 men underwent PSA sampling at the same intervals without ejaculation.

Main Results:

• Total and free PSA levels showed statistically significant increases at 1 and 5 hours post-ejaculation compared to baseline.
• Complexed PSA levels did not exhibit significant changes after ejaculation.
• Only 2.12% of patients had PSA levels affected enough by ejaculation to potentially alter biopsy decisions.

Conclusions:

• Ejaculation can transiently elevate serum PSA, particularly total and free PSA.
• Clinically significant changes in PSA due to ejaculation are infrequent but may be relevant for borderline cases.
• For borderline PSA results, questioning ejaculation history and retesting 24 hours post-ejaculation is recommended. Complexed PSA appears unaffected.