Clinical implications of the rise and fall of prostate specific antigen after laser prostatectomy.

OBJECTIVE

To characterize the serum kinetics of prostate specific antigen (PSA) after visual laser ablation of the prostate (VLAP).

PATIENTS AND

METHODS

The PSA values of 45 patients were measured at 24 h and at 1, 4, 12, 26 and 52 weeks after VLAP and the changes assessed in relation to symptom scores, urinary flow rates and prostate size.

RESULTS

After an initial rise immediately after VLAP, the serum PSA level declined. At 24 h, the PSA value reached a mean level 23 times higher than the PSA level before VLAP and then took a mean of 78 days to reach a new baseline. The mean decrease of the subsequent baseline value relative to that before treatment was 1.7 ng/mL. The prostatic size and energy applied correlated positively with the rise in PSA 24 h after VLAP. The rise in maximal urinary flow after VLAP, the decrease in the symptom score and residual urine volume did not correlate with the rise in PSA level 24 h after VLAP or with the time to reach a value halfway between the level at 24 h and the new baseline value.

CONCLUSIONS

The pattern of the increase in serum PSA level and decline after VLAP was not predictive of the clinical outcome of therapy.