Effect of Different Manipulations on Serum Prostate-Specific Antigen (PSA) Level in Patients with Symptomatic Benign Prostatic Hyperplasia and Suspicion of Carcinoma Prostate

Background: Prostate specific antigen is an organ specific marker. A temporary rise in prostate specific antigen serum level has been reported in various situations like, digital rectal examination, urethral catheterization, transurethral resection of prostate and transrectal ultrasound guided prostatic needle biopsy. Methodology: This comparative study is conducted at Department of Urology and Renal Transplantation Div, HQ. Teaching Hospital Mirpur Azad Kashmir from 1st June 2017 to 31st May 2018. Patients with symptomatic benign prostate hyperplasia and suspicion of carcinoma prostate on digital rectal examination with age above 50 years were included. All patients were divided into four groups. Group A comprised, patients who underwent digital rectal examination. Group B comprised, patients who underwent transurethral resection of prostate. Group C comprised, patients who underwent transurethral Foley catheterization due to retention of urine. Group D comprised, patients who underwent transrectal ultrasound guided prostatic needle biopsy for suspicion of ca prostate on digital rectal examination. Serum PSA was detected by enzyme linked immunosorbent serum assay (ELISA) method. Results: In group A pre manipulation mean serum PSA level was 1.22ng/ml, after 30 minutes it was 2.52ng/ml, where as after 72 hrs mean serum PSA level was 1.56ng/ml and after one week it dropped to 1.1ng/ml. In group B pre manipulation mean serum PSA level was 3.41ng/ml, after 30 minutes of manipulation it was 29.89ng/ml, after 72 hours and one week of manipulation it was 8.22ng/ml and 4.25ng/ml respectively and after 2 weeks it dropped to 3.78ng/ml. In group C pre manipulation mean serum PSA level was 2.81ng/ml, after 30 minutes it was 4.54ng/ml, where as after 72 hrs and 1 week of manipulation it was 3.76ng/ml and 2.40ng/ml respectively. In group D pre manipulation mean serum PSA level was 2.61ng/ml, after 30 minutes it was 4.53ng/ml, where as after 72 hrs and 1 week of manipulation it was 3.42ng/ml and 2.56ng/ml respectively. Conclusion: There is significant rise in serum prostate specific antigen after different manipulations except DRE.