Abstract
Objectives: Prostatic specific antigen (PSA) is an organ (prostate) specific marker. A temporary rise in PSA serum level has been reported in various situations like prostate cancer, prostate biopsy, prostatitis and after prostate resection. The purpose of this study was to determine the effect of an indwelling urethral catheter on serum PSA level in-patients with benign prostatic hypertrophy (BPH), presenting with urinary retention.
Patients and methods: Sixty-two male patients presented in the emergency room with urinary retention due to prostate enlargement. Serum PSA level was examined during indwelling catheter after determination of sterile urine culture and 1 month after catheter removal. Parameters like amount of residual urine at retention prostate volume and serum urea and creatinine levels were recorded. PSA serum levels before catheterization (in whom it was available) during indwelling catheter and after catheter removal were compared.
Results: Of the 62 patients in this study 21 (34%) were excluded, 11 were not weaned from the catheter and did not have a recent PSA level prior to retention, 2 due to prostate cancer, 4 had positive urine culture despite antibiotic treatment and 4 patients were lost to follow up. Forty-one eligible patients were included. PSA serum levels during indwelling catheter ranged from 0.04 and 32.7 ng/ml (mean 8.82). PSA levels without catheter ranged between 0.2 and 11.6 ng/ml (mean 4.47). All patients with age related elevated PSA underwent full investigation. In the 20 patients with normal baseline there was no statistical difference between PSA with and without catheter. In the group of 21 patients with PSA 4 ng/ml at baseline a significant difference was found in the marker's level between patients with and without catheter.
Conclusion: Indwelling catheter in-patients with BPH who underwent urinary retention did cause a significant elevation of PSA serum levels in those patients having an elevated PSA at baseline and did not change significantly in those with normal baseline levels.
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