The Effect of Acute Urinary Retention on The Accuracy of Serum Prostate-Specific Antigen Level Measurements

Abstract

ABSTRACT:BACKGROUND:The level of PSA in serum is increased by inflammation of the prostate, urinary retention,prostaticinfection, benign prostatic hyperplasia,prostate cancer, and prostatic manipulation. [3]OBJECTIVE:To study the effect of acute urinary retention on the serum prostate-specific antigen (PSA)concentration.METHODS:Blood samples for serum PSA measurement were obtained (PSA1), and an indwelling urethralcatheter was inserted for 2 weeks. Before catheter removal, a second blood sample for measurementof serum PSA level (PSA2) was obtained. In patients who were able to void, a third sample wasobtained 3 weeks later (PSA3). In the first and second visits, digital rectal examinations (DRE1,DRE2) were performed to assess prostate volume. Mean PSA levels (PSA1, PSA2, and PSA3) andprostate volumes (DRE1, DRE2) were compared.RESULTS:Fourty-two patients with a mean age of 70.18 years (range 56 to 85 years) participated in thisstudy.mean PSA level at the time of AUR (PSA1) was 7.02 ng/mL (median, 5.8 ng/mL; range, 0.9 to30.4 ng/mL). The mean PSA2 level was 5.5 ng/mL (median, 3.9 ng/mL; range, 0.7 to 39 ng/mL),lower than the PSA1 level .This association was statistically non significant P > 0.05. The meanprostate volume at the time of DRE1 (43.4 mL; median, 45 mL; range, 30 to 60 mL) wassignificantly higher than at DRE2 (37.8 mL; median, 40 mL; range, 25 to 50 mL) (P < 0.001).PSA3 was measured in 42 patients 4 weeks after retention (2 weeks after catheter removal). In thisgroup of patients, mean PSA2 and PSA3 levels were 5.5 ng/mL and 5.1 ng/mL, respectively (median,3.9 and 3.5, respectively, P > 0.05).CONCLUSION:Acute urinary retention can increase serum PSA levels. In this series, we found that this effect maycontinue up to 2 weeks.