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- Title
Change in Serum Prostate Specific Antigen Concentration after Holmium Laser Enucleation of the Prostate: A Marker for Completeness of Adenoma Resection?
- Authors
William W. Tinmouth; Enmar Habib; Samuel C. Kim; Ramsay L. Kuo; Ryan F. Paterson; Colin L. Terry; Mostafa Elhilali; James E. Lingeman
- Abstract
Background and Purpose: Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for the treatment of benign prostatic hyperplasia (BPH). To date, changes in serum prostate specific antigen (PSA) after HoLEP have not been published. We hypothesized that HoLEP produces a diminution in PSA similar to that produced by the gold-standard therapies for BPH. To test this hypothesis, we have examined PSA data before and after HoLEP from two institutions performing high volumes of this procedure.Patients and Methods: Between August 1998 and September 2004, 509 HoLEPs were performed at two institutions for which complete PSA data were available. Preoperative demographic and transrectal ultrasonography (TRUS) volume measurements were recorded; postoperative pathology and TRUS volume were obtained. Change in PSA as a function of the weight of prostate resected and the relation of preoperative TRUS volume to PSA was determined.Results: The average weight of adenoma resected was 49.8 g (range 5300 g) in the McGill group and 90.4 g (range 7.9312 g) in the Methodist Hospital group. The mean decrease in PSA was 81.7% in the McGill group (range 6.01.1 ng/mL; P < 0.0001) and 86.0% in the Methodist Hospital group (range 8.61.2 ng/mL; P < 0.0001). Log transformed preoperative PSA correlated well with TRUS volume (r = 0.45), as did the weight of adenoma resected with absolute change in PSA (r = 0.38). The TRUS volume decreased significantly, from 111.9 cc to 26.5 cc, in the Methodist Hospital group (P < 0.0001).Conclusion: The HoLEP procedure produces a significant diminution in PSA that correlates well with the weight of adenoma resected. Measurement of PSA may be a useful tool for the objective assessment of ablative therapies for BPH, as the reduction in PSA corresponds well with the amount of adenoma removed.
- Subjects
EXOCRINE glands; TUMORS; ADENOMA; THERAPEUTICS
- Publication
Journal of Endourology, 2005, Vol 19, Issue 5, p550
- ISSN
0892-7790
- Publication type
Article