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Treatment of chronic prostatitis lowers serum prostate specific antigen.
J Urol. 2002 Apr; 167(4):1723-6.JU

Abstract

PURPOSE

We evaluated men with documented chronic prostatitis and elevated serum prostate specific antigen (PSA) to determine whether treatment with antibiotics and anti-inflammatory drugs lowers serum PSA.

MATERIALS AND METHODS

We retrospectively reviewed the records of 95 men who presented with serum PSA greater than 4 ng./ml. and were subsequently diagnosed with chronic prostatitis with greater than 10 white blood cells per high power field in expressed prostatic excretions. Patients meeting these criteria were treated with a 4-week course of antibiotics and a nonsteroidal anti-inflammatory agent. In all patients followup PSA was determined within 2 months of treatment.

RESULTS

Mean PSA decreased 36.4% from 8.48 ng./ml. before to 5.39 after treatment (p <0.001). In 44 patients (46.3%) serum PSA decreased to below 4 ng./ml. (mean 2.48) and these patients no longer had an indication for biopsy. In the remaining 51 patients serum PSA remained elevated at greater than 4 ng./ml. and they underwent double sextant transrectal ultrasound guided biopsy. Pathological study showed prostate cancer in 13 cases (25.5%), chronic inflammation in 37 (72.5%) and only benign prostatic hypertrophy in 1 (1.05%). PSA in the 13 patients with prostate cancer decreased with treatment only 4.8% from 8.32 to 7.92 ng./ml. (p >0.05). Followup PSA at a mean of 11.4 months was determined in 19 of the 44 men who responded to treatment. Mean PSA increased only 4.5% from 2.35 to 2.46 ng./ml. (p >0.05) during this followup interval.

CONCLUSIONS

In almost half of the patients diagnosed with elevated PSA and chronic prostatitis serum PSA normalized with treatment and there was no longer an indication for transrectal ultrasound guided biopsy. Our study suggests that chronic prostatitis is an important cause of elevated PSA and when it is identified, treatment can decrease the percent of negative biopsies.

Authors+Show Affiliations

Department of Urology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11912396

Citation

Bozeman, Caleb B., et al. "Treatment of Chronic Prostatitis Lowers Serum Prostate Specific Antigen." The Journal of Urology, vol. 167, no. 4, 2002, pp. 1723-6.
Bozeman CB, Carver BS, Eastham JA, et al. Treatment of chronic prostatitis lowers serum prostate specific antigen. J Urol. 2002;167(4):1723-6.
Bozeman, C. B., Carver, B. S., Eastham, J. A., & Venable, D. D. (2002). Treatment of chronic prostatitis lowers serum prostate specific antigen. The Journal of Urology, 167(4), 1723-6.
Bozeman CB, et al. Treatment of Chronic Prostatitis Lowers Serum Prostate Specific Antigen. J Urol. 2002;167(4):1723-6. PubMed PMID: 11912396.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of chronic prostatitis lowers serum prostate specific antigen. AU - Bozeman,Caleb B, AU - Carver,Brett S, AU - Eastham,James A, AU - Venable,Dennis D, PY - 2002/3/26/pubmed PY - 2002/5/31/medline PY - 2002/3/26/entrez SP - 1723 EP - 6 JF - The Journal of urology JO - J. Urol. VL - 167 IS - 4 N2 - PURPOSE: We evaluated men with documented chronic prostatitis and elevated serum prostate specific antigen (PSA) to determine whether treatment with antibiotics and anti-inflammatory drugs lowers serum PSA. MATERIALS AND METHODS: We retrospectively reviewed the records of 95 men who presented with serum PSA greater than 4 ng./ml. and were subsequently diagnosed with chronic prostatitis with greater than 10 white blood cells per high power field in expressed prostatic excretions. Patients meeting these criteria were treated with a 4-week course of antibiotics and a nonsteroidal anti-inflammatory agent. In all patients followup PSA was determined within 2 months of treatment. RESULTS: Mean PSA decreased 36.4% from 8.48 ng./ml. before to 5.39 after treatment (p <0.001). In 44 patients (46.3%) serum PSA decreased to below 4 ng./ml. (mean 2.48) and these patients no longer had an indication for biopsy. In the remaining 51 patients serum PSA remained elevated at greater than 4 ng./ml. and they underwent double sextant transrectal ultrasound guided biopsy. Pathological study showed prostate cancer in 13 cases (25.5%), chronic inflammation in 37 (72.5%) and only benign prostatic hypertrophy in 1 (1.05%). PSA in the 13 patients with prostate cancer decreased with treatment only 4.8% from 8.32 to 7.92 ng./ml. (p >0.05). Followup PSA at a mean of 11.4 months was determined in 19 of the 44 men who responded to treatment. Mean PSA increased only 4.5% from 2.35 to 2.46 ng./ml. (p >0.05) during this followup interval. CONCLUSIONS: In almost half of the patients diagnosed with elevated PSA and chronic prostatitis serum PSA normalized with treatment and there was no longer an indication for transrectal ultrasound guided biopsy. Our study suggests that chronic prostatitis is an important cause of elevated PSA and when it is identified, treatment can decrease the percent of negative biopsies. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/11912396/Treatment_of_chronic_prostatitis_lowers_serum_prostate_specific_antigen_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-5347(05)65186-5 DB - PRIME DP - Unbound Medicine ER -