Abstract |
The aim of thiw study is to evaluate the usefulness of prostate specific antigen (PSA) in the early detection of prostatic cancer and to assess the effect of transurethral resection of the prostate (TUR-P) versus open prostatectomy (OP) on the serum PSA concentration, in patients with histologically confirmed benign prostatic hyperplasia (BPH) and determine the time required for the serum PSA level greater than 4.0 ng/ml, underwent both digital rectal examination (DRE) and transrectal ultrasound (TRUS). Ultrasound guided prostate biopsies were performed in the men with abnormal findings on DRE, TRUS or both. Serum PSA value 4.1-10.0 ng/ml and 18 (2.4%) had a PSA value >10.0 ng /ml. A total of 16 carcinomas (41%) was detected in 39 men who had ultrasound guided prostate biopsies. If DRE alone had been used to screen the men whohad cancer, 5 of the 16 (31.2%) would have been missed. We also studied 53 patients with obstuctive benign prostatic hyperplasia scheduled for transurethral resection of the prostate (TUR-P, 35 patients) or open prostatectomy (OP, 18 patients). The serum PSA concentration was measured before and immediately after the procedure on days 1, 3, 5, 7 after the operation, at 3-4 days intervalsfor three weeks or longer and 3 months after prostatectomy. Statistical analysis was made by ANOVA one way with Student's t-test where appropriate with statistical significance at 5% level. The main pre-procedure PSA value of the TUR-P group was a significant PSA rise (102.68 ng/ml), but in the OP group the rise was minimal (14.04ng/ml).
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