Prostatic involvement in men with febrile urinary tract infection as measured by serum prostate-specific antigen and transrectal ultrasonography.
OBJECTIVE
To determine the frequency of prostatic involvement in men with community-acquired febrile urinary tract infection.


METHODS
This prospective study included 70 men (18-85 years old) who had a fever of >/=38.0 degrees C, symptoms or signs of urinary tract infection and a positive urine culture. Serum prostate-specific antigen (PSA) was measured and transrectal ultrasonography of the prostate and seminal vesicles performed during the acute phase of the disease and during a 1-year follow-up.


RESULTS
Although only six patients had a tender prostate on digital rectal examination, the initial serum PSA level was elevated in 58 (83%) patients (median 14 ng/mL, range 0.54-140). There was no correlation between PSA levels, patient age, inflammatory response to infection or presence of positive blood cultures. Despite a rapid decline in PSA level after one month, there was a protracted decrease in some patients. After 3 months the median prostate volume was reduced by 31% (range 11-54; P<0.001) in 46 of 55 patients examined, and the width of the right and left seminal vesicle was reduced by 14% and 22%, respectively. The reductions in PSA and prostate volume were significantly correlated (r=0.36, 95% confidence interval 0.09-0.58; P=0.01).


CONCLUSIONS
These results show that the prostate and seminal vesicles are frequently involved in men with febrile urinary tract infection and that PSA may be a useful marker of prostatic infection. The slow decline of PSA levels in some patients after appropriate antibiotic treatment indicates a protracted healing process and should be considered when PSA is used to detect prostate cancer.
Ulleryd
P
P
Department of Infectious Diseases, Sahlgrenska University Hospital, Göteborg, Sweden.
Zackrisson
B
B
Aus
G
G
Bergdahl
S
S
Hugosson
J
J
Sandberg
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000379:methods; D017714:Community-Acquired Infections / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D004927:Escherichia coli Infections / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011469:Prostatic Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging
D015415:Biomarkers; D017430:Prostate-Specific Antigen