Transvezikal Prostatektomi veTransuretral Prostatektomi Uygulanan Hastalarda Çıkarılan Doku Miktarı ile PSA Düşüşü Arasıındaki İlişki

Amaç: Transvezikal prostatektomi (TVP) ve transuretral prostatektomi (TURP)' de çıkartılan doku miktarlarıyla PSA düzeylerindeki düşüş arasındaki ilişkinin incelenmeyi amaçladık . Gereç ve yöntem: Patoloji sonuçları adenomyomatoz hiperplazi gelen TVP yapılan 79 hasta ve TUR-P yapılan 135 hasta çalışmaya dahil edildi. Hastaların ortalama yaşı TVP grubunda 68.2, TURP grubunda 65.7 idi. Tüm hastalara operasyon öncesi PRM, serumda total ve serbest PSA, TRUS, üroflovmetre ve IPSS yapıldı. Postoperatif 3. ayda PSA tekrar ölçüldü ve total ve serbest PSA değerlerindeki azalma ile rezeke edilen doku miktarı arasındaki korelasyon araştırıldı. Bulgular: TVP de prostat dokusunun % 81.4' ü çıkarılarak total PSA da % 79, serbest PSA da %58 düşüş saptanırken; TURP grubunda prostat dokusunun %52' si çıkarılarak total PSA da %47, serbest PSA da %42'lik bir düşüş izlenmiştir (p

Correlation BetweenThe Amountof Extracted Tissueand PSA Levels Patients TreatedwithTransurethral Resectionof The Prostateand Transvezical Prostatectomy

Objective: To investigate the correlation between extracted tissue amount and prostate specific antigen (PSA) decline in patients treated with transvesical prostatectomy (TVP) and transurethral resection of prostate (TURP). Methods: A total of 79 patients who underwent TVP and 135 patients who underwent TUR-P with histopathologically, diagnosis of BPH was confirmed were enrolled to the study. The mean age of patients was 68.2 years in TVP group and 65.7 years in TURP group. All patients had DRE, serum total and free PSA, TRUS, uroflowmeter, and IPSS before the operation. In the postoperative 3rd month, the PSA measurement was repeated, and the correlation between the decrease in total and free PSA levels and the amount of tissue resected during the procedure was investigated. Results: In TVP group mean enucleated prostate volume was 81.4%. The decrease in total and free PSA levels was 79% and 58%, respectively. In TURP group mean resected prostate volume was 52%. The decrease in total and free PSA levels was 47% and 42%, respectively (p<0.001). For 1 g of prostate mass enucleated in TVP group, the total and free PSA levels decreased 0.145 ng/ml and 0.03 ng/ml, respectively. In TURP group for 1 g of prostate mass resected, the total and free PSA levels decreased 0.103 ng/ml and 0.013 ng/ml, respectively. Conclusion: Total-free PSA levels decrease with the amount of tissue extracted during TURP in BPH patients

___

  • 1. Atan A, Horn T, Hansen F, et al. Prostate Specific Antigen and Benign Prostatic Hyperplasia. Scand J Urol Nephrol. 1996;30:299-302.
  • 2. Recker F, Kwiatkowski MK, Pettersson K, et al. Enhanced expression of prostate-specific antigen in the transition zone of the prostate. A characterization following prostatectomy for benign hyperplasia. Eur Urol 1998;33:549-55.
  • 3. Scattoni V, Raber M, Montorsi F, et al. Percent of free serum prostatespecific antigen and histological findings in patients undergoing open prostatectomy for benign prostatic hyperplasia. Eur Urol 1999;36:621-30.
  • 4. Coker CB, Coptcoat MJ, Mulvin A, et al. The release of free prostate specific antigen into the circulation during transurethral resection of the prostate: Kinetics and interaction with serum protease inhibitors. Br J Urol 1998 Jan;81:105-8.
  • 5. Stamey TA, Yang N, Hay AR, et al. E. Prostate specific antigen as a serum marker for adenocarcinoma of the prostate. New Engl J Med 1987 Oct 8;317:909-916.
  • 6. Lloyd SN, Collins GN, McKelvie GB, et al. Predicted and actual change in serum PSA following prostatectomy for BPH. Urology 1994 Apr;43: 472-9.
  • 8. Antunes AA, Srougi M, Coelho RF, et al. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected? Int Braz J Urol 2009;35:683-91.
  • 9. Scattoni V, Raber M, Montorsi F, et al. Percent of free serum prostatespecific antigen and histological findings in patients undergoing open prostatectomy for benign prostatic hyperplasia. Eur Urol 1999 Dec;36:621-30.
Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -