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Clinical implications of the rise and fall of prostate specific antigen after laser prostatectomy
M P van Iersel1, C M Thomas, W P Witjes
1Department of Urology, University Hospital of Nijmegen St Radboud, The Netherlands.
Objective:
To characterize the serum kinetics of prostate specific antigen (PSA) after visual laser ablation of the prostate (VLAP).
Patients And Methods:
The PSA values of 45 patients were measured at 24 h and at 1, 4, 12, 26 and 52 weeks after VLAP and the changes assessed in relation to symptom scores, urinary flow rates and prostate size.
Results:
After an initial rise immediately after VLAP, the serum PSA level declined. At 24 h, the PSA value reached a mean level 23 times higher than the PSA level before VLAP and then took a mean of 78 days to reach a new baseline. The mean decrease of the subsequent baseline value relative to that before treatment was 1.7 ng/mL. The prostatic size and energy applied correlated positively with the rise in PSA 24 h after VLAP. The rise in maximal urinary flow after VLAP, the decrease in the symptom score and residual urine volume did not correlate with the rise in PSA level 24 h after VLAP or with the time to reach a value halfway between the level at 24 h and the new baseline value.
Conclusions:
The pattern of the increase in serum PSA level and decline after VLAP was not predictive of the clinical outcome of therapy.