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Original Research

To Spare or not to Spare? Bladder Neck and Robotic Radical Prostatectomy


1 Kayseri Şehir Hastanesi, Üroloji Kliniği, Kayseri
2 Koç Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul
 


DOI : 10.33719/yud.488845
New J Urol. 2019; 14 (3): 144-151

Abstract

Objective: Acute urinary retention (AUR) is one of the most important complications in be- nign prostate hyperplasia (BPH) patients and its treatment is generally urethral catheterization in acute period. Studies are showing that AUR and urethral catheter placement may cause an increase in serum PSA levels. Our objective in this study was to investigate the relationship between in- creased PSA levels and prostate cancer (PCa) inci- dence in the patient group after AUR and urethral catheter placement.

Material and Methods: Seventy-seven pa- tients who had an indwelling urethral catheter due to AUR, performed prostate biopsy due to high PSA levels and then surgical treatment for clinic BPH were retrospectively examined. Age, pros- tate volumes, pre-biopsy total serum PSA and PSA densities were noted. Total serum PSA rates, PSA densities and prostate volumes were compared for the groups that PCa was detected (n=6) and not detected (n=71) according to biopsy or surgical specimen results.

Results: Mean age of the patients was 65.2±3.9 years. Mean prostate volume was mea- sured as 64.1±12.8 g, mean serum total PSA level as 9.2±4.2 ng/mL and mean serum PSA density as 0.15±0.08 mg/mL/g. In PSA groups with a serum total PSA level of ≤4.0, 4-10, 10-20 and >20, PCa prevalence rates were detected 0%, 4.3%, 13.4% and 20%, respectively. Total PSA levels and PSA densities were found statistically higher in PCa detected group.

Conclusions: PCa incidence is low in patients who were placed urethral catheter after AUR. For these patients prostate biopsy should be per- formed only in chosen cases.

Keywords: acute urinary retention, biopsy, prostate cancer
 


Abstract

Objective: Acute urinary retention (AUR) is one of the most important complications in be- nign prostate hyperplasia (BPH) patients and its treatment is generally urethral catheterization in acute period. Studies are showing that AUR and urethral catheter placement may cause an increase in serum PSA levels. Our objective in this study was to investigate the relationship between in- creased PSA levels and prostate cancer (PCa) inci- dence in the patient group after AUR and urethral catheter placement.

Material and Methods: Seventy-seven pa- tients who had an indwelling urethral catheter due to AUR, performed prostate biopsy due to high PSA levels and then surgical treatment for clinic BPH were retrospectively examined. Age, pros- tate volumes, pre-biopsy total serum PSA and PSA densities were noted. Total serum PSA rates, PSA densities and prostate volumes were compared for the groups that PCa was detected (n=6) and not detected (n=71) according to biopsy or surgical specimen results.

Results: Mean age of the patients was 65.2±3.9 years. Mean prostate volume was mea- sured as 64.1±12.8 g, mean serum total PSA level as 9.2±4.2 ng/mL and mean serum PSA density as 0.15±0.08 mg/mL/g. In PSA groups with a serum total PSA level of ≤4.0, 4-10, 10-20 and >20, PCa prevalence rates were detected 0%, 4.3%, 13.4% and 20%, respectively. Total PSA levels and PSA densities were found statistically higher in PCa detected group.

Conclusions: PCa incidence is low in patients who were placed urethral catheter after AUR. For these patients prostate biopsy should be per- formed only in chosen cases.

Keywords: acute urinary retention, biopsy, prostate cancer