Does ischemia-induced prostate damage during cardiac surgery involving cardiopulmonary bypass cause bladder outlet obstruction?
OBJECTIVE
This study sought to investigate whether ischemia-induced prostate damage during cardiac surgery involving cardiopulmonary bypass causes bladder outlet obstruction.


METHODS
The study involved 37 men who underwent elective cardiac surgery involving cardiopulmonary bypass. Prostate-specific antigen (PSA) levels were determined preoperatively (baseline) and on postoperative days 1, 5, and 30. In 4 cases, the PSA level after the operation was unchanged from the preoperative level, so these 4 men were excluded from the study. In the remaining 33 patients, symptoms of bladder outlet obstruction were assessed using the International Prostate Symptom Score. Each subject completed this test preoperatively and 3, 6 and 9 months postoperatively, and the means scores at these time points were compared. The effects of patient age, operative time, CPB time, and aortic clamping time on postoperative increases in PSA levels were investigated.


RESULTS
Thirty-three (89.2%) of the 37 men exhibited increased postoperative PSA levels compared to baseline. The mean PSA level for the 33 cases on day 5 was significantly higher than the baseline mean, but the mean levels on postoperative days 1 and 30 were comparable to baseline. Nine (24.3%) of the 33 men had postoperative PSA levels greater than 4.0 ng/dl (the upper normal limit). There was no significant difference between preoperative and postoperative International Prostate Symptom Scores.


CONCLUSIONS
The study indicates that men's PSA levels are, indeed, increased after cardiac surgery with cardiopulmonary bypass. However, in 9 months of follow-up, there was no association between this PSA rise and development of BOO, according to International Prostate Symptom Scores.
Guvel
Sezgin
S
Department of Urology, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Adana, Turkey. sezginguvel@mynet.com
Turkoz
Riza
R
Egilmez
Tulga
T
Kilinc
Ferhat
F
Yaycioglu
Ozgur
O
Atalay
Hakan
H
Ozkardes
Hakan
H
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000098:blood supply*; D017430:Prostate-Specific Antigen / Q000097:blood; D013903:Thoracic Surgery / Q000379:methods; D001748:Urinary Bladder Neck Obstruction / Q000097:blood / Q000209:etiology*
D017430:Prostate-Specific Antigen