Kocaeli Med J. 2015; 4(1): 1-4

Correlation between the amount of extracted tissue and PSA levels patients treated with transurethral resection of the prostate and transvezical prostatectomy

Emre Can Polat¹, Levent Ozcan², Alper Otunctemur³, Emin Ozbek³, Þinasi Yavuz Önol^4
1Istanbul Medipol University,school Of Medicine, Department Of Urology,ýstanbul,turkey
²Derince Training And Research Hospital, Department Of Urology, Kocaeli,turkey
³Okmeydani Training And Research Hospital, Department Of Urology,ýstanbul,turkey
⁴Bezmi Alemuniversity,school Of Medicine, Department Of Urology,ýstanbul,turkey

INTRODUCTION: 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.
DISCUSSION AND CONCLUSION: Total-free PSA levels decrease with the amount of tissue extracted during TURP in BPH patients.

Keywords: Benign prostatic hiperplasia, prostate specific antigen, transurethral resection of prostate, transvesical prostatectomy

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Transvezikal prostatektomi ve transüretral prostatektomi uygulanan hastalarda çýkarýlan doku miktarý ile PSA düþüþü arasýndaki iliþki

Emre Can Polat¹, Levent Ozcan², Alper Otunctemur³, Emin Ozbek³, Þinasi Yavuz Önol^4
1Ýstanbul Medipol Üniversitesi, Týp Fakültesi, Üroloji Abd,istanbul,türkiye
²Derince Eðitim Ve Araþtýrma Hastanesi,üroloji Kliniði, Kocaeli,türkiye
³Okmeydaný Eðitim Ve Araþtýrma Hastanesi,üroloji Kliniði,istanbul, Türkiye
⁴Bezmi Alem Üniversitesi, Týp Fakültesi, Üroloji Abd,istanbul,türkiye

GÝRÝÞ ve AMAÇ: Transvezikal prostatektomi (TVP) ve transuretral prostatektomi (TURP)’ de çýkartýlan doku miktarlarýyla PSA düzeylerindeki düþüþ arasýndaki iliþkinin incelenmeyi amaçladýk
YÖNTEM ve GEREÇLER: Patoloji sonuçlarý adenomyomatoz hiperplazi gelen TVP yapýlan 79 hasta ve TUR-P yapýlan 135 hasta çalýþmaya dahil edildi. Hastalarýn ortalama yaþý TVP grubunda 68.2, TURP grubunda 65.7 idi. Tüm hastalara operasyon öncesi PRM, serumda total ve serbest PSA, TRUS, üroflovmetre ve IPSS yapýldý. Postoperatif 3. ayda PSA tekrar ölçüldü ve total ve serbest PSA deðerlerindeki azalma ile rezeke edilen doku miktarý arasýndaki korelasyon araþtýrýldý.
BULGULAR: TVP de prostat dokusunun % 81.4’ ü çýkarýlarak total PSA da % 79, serbest PSA da %58 düþüþ saptanýrken; TURP grubunda prostat dokusunun %52’ si çýkarýlarak total PSA da %47, serbest PSA da %42’lik bir düþüþ izlenmiþtir (p<0.001). Rezeke edilen 1 gr prostat kütlesine karþýlýk TVP grubunda total PSA’ da 0.145 ng/ml, serbest PSA’ da 0.03 ng/ml azalma; TURP grubunda total PSA’ da 0.103 ng/ml, serbest PSA’ da 0.013 ng/ml azalma bulundu.
TARTIÞMA ve SONUÇ: BPH nedeniyle TURP yapýlan hastalarda, çýkartýlan doku miktarýna paralel olarak total ve serbest PSA deðerlerinde azalma olur.

Anahtar Kelimeler: Benign prostat hiperplazisi, prostat spesifik antijen, transüretral prostat rezeksiyon, transvezikal prostatektomi

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