Reduction of prostate-specific antigen after tamsulosin treatment in patients with elevated prostate-specific antigen and lower urinary tract symptoms associated with low incidence of prostate cancer at biopsy.
OBJECTIVE
To evaluate the effect of tamsulosin on reducing the serum levels of prostate-specific antigen (PSA) in patients with lower urinary tract symptoms and an elevated PSA level.


METHODS
From June 2004 to July 2006, patients with lower urinary tract symptoms, a PSA level of >or=4 ng/mL, and a maximal flow rate of <15 mL/s received tamsulosin 0.4 mg daily for 2 months. They were then scheduled for 12-core prostate biopsy. PSA determination and a uroflow study were performed before biopsy.


RESULTS
A total of 80 patients completed the present study. The mean patient age was 66.3 years, and the mean PSA level was 7.8 +/- 8.4 ng/mL at baseline and 7.1 +/- 9.1 ng/mL after treatment (P < .001). A total of 29 patients (36.25%) were diagnosed with prostate cancer from the biopsy findings. A significant increment in the PSA level was observed in patients with prostate cancer (6.7 versus 7.9 ng/mL; P = .002). A significant decrease in the PSA level was observed in patients with negative biopsy findings (6.9 versus 5.1 ng/mL, P = .000). Of the 38 patients with a decrease in the PSA level, 1 (2.6%) was diagnosed with prostate cancer and 37 (97.4%) with an benign prostatic hyperplasia/prostatitis. Of the 42 patients with no change in the PSA level, 28 (66.7%) had prostate cancer and 14 (33.3%) had negative findings. A change in PSA level after treatment gave a sensitivity of 96.6%, specificity of 72.5%, and diagnostic accuracy of 81% for prostate cancer.


CONCLUSIONS
Treatment with tamsulosin seemed to reduce the PSA levels and identified patients at high risk of prostate cancer.
Tubaro
Andrea
A
Department of Urology, Sant'Andrea Hospital 2nd School of Medicine, "La Sapienza" University of Rome, Rome, Italy. andrea.tubaro@mac.com
De Nunzio
Cosimo
C
Mariani
Simone
S
Trucchi
Alberto
A
Miano
Roberto
R
Vicentini
Carlo
C
Miano
Lucio
L
D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology*; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood* / Q000187:drug effects*; D011471:Prostatic Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D053448:Prostatism / Q000097:blood* / Q000150:complications; D013449:Sulfonamides / Q000494:pharmacology*; D000077409:Tamsulosin
D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D017430:Prostate-Specific Antigen; D000077409:Tamsulosin