Introduction: Prostate-specific antigen (PSA) variations after photoselective vaporization of the prostate are an unsolved question.
Method: We included prospectively 308 patients who underwent GreenLight® prostate vaporization for prostatic hyperplasia between 2005 and 2013. We excluded patients with prostate cancer and those with concomitant prostate biopsies. Serum PSA levels were measured before and after procedure at 1, 6, 12, 24, 36 and 48 months.
Results: The median preoperative PSA was 4.50 ng/ml, it decreased to 2.41 ng/ml at 1 month (47% reduction), 2.17 ng/ml at 6 months (52% reduction), 2.30 ng/ml at 1 year (49% reduction), 2.40 ng/ml at 2 years (47% reduction), 2.31 ng/ml at 3 years (49% reduction), and 2.54 ng/ml at 4 years (44% reduction) (p values were all < 0.0001). Median PSA nadir at 6 months was significantly different from the median PSA at 1, 2, 3 and 4 years (respectively p=0.0046, p=0.0017, p=0.0006, and p=0.01). Patients who received ≤ 3000 J/cc had a significant trend to a PSA re-ascension after 6 months. Patients who received ≥4000 J/cc did not show any significant PSA re-ascension during the 4 years after procedure. Energy was correlated with the PSA re-ascension in univariate and multivariate analysis.
Conclusions: PSA significantly decreased by half 1 month after procedure, reached its nadir at 6 months and showed a slight progressive re-ascension during the 4 following years. Applying an energy rate ≥4000 J/cc of prostate induced PSA stability over time whereas energy ≤ 3000 J/cc induced a re-ascension of the PSA after 6 months.
Written by:
Lebdai S, Prezelin Y, Pereira H, Bruyere F. Are you the author?
Angers University Hospital, Urology, Urology department, CHU Angers, 4 rue Larrey, Angers, France, 49933.
Reference: J Endourol. 2013 Oct 24. Epub ahead of print.
doi: 10.1089/end.2013.0522
PubMed Abstract
PMID: 24156628
