title: Changes in S-PSA after transurethral resection of prostate and its correlation to postoperative outcome.
abstract: OBJECTIVE
  Although different factors may affect prostate-specific antigen (PSA) reduction after transurethral resection of prostate, an approximate 70 % decrease from baseline is expected. We hereby undertook a prospective study to analyze changes in serum PSA (S-PSA) after transurethral resection of the prostate (TURP) and its correlation with the residual prostatic weight and clinical symptom score improvement.
  
  
  METHODS
  Seventy patients who underwent TURP for bladder outlet obstruction were included in the study. Patient's evaluation included history, International Prostate Symptom Score (IPSS), S-PSA, Qmax, post-void residual urine and prostate size. On follow-up, trans-rectal ultrasonography, S-PSA and IPSS score were calculated. Patients were analyzed in three groups based on the amount of tissue resected: less than 40, 40-60 and more than 60 % tissue resected.
  
  
  RESULTS
  Preoperative prostate size, IPSS, Qmax and S-PSA were 62.56 ml, 23.84, 11.68 ml/sec and 3.3 ng/ml. There was a significant decrease in the IPSS score, prostate size and S-PSA levels after TURP in all the three groups. There was a significant positive correlation of the amount of tissue resected with change in S-PSA levels, change in IPSS score and postoperative IPSS score. Reduction in IPSS score significantly correlated with patient's satisfaction.
  
  
  CONCLUSIONS
  The amount of tissue resected in TURP has a direct bearing on the S-PSA levels, change in symptom score and residual prostate volume. It is the percentage change in IPSS score and not the absolute value of IPSS, which has a direct bearing with the patient satisfaction and with the amount of tissue resected. Percentage fall in S-PSA by 70 % was found to be predictor of more than 60 % resection.
authors.affiliation: Sir Ganga Ram Hospital, New Delhi, India. drmrinalpahwa@gmail.com
authors.forename: Mrinal
authors.initials: M
authors.lastname: Pahwa
authors.forename: Mayank
authors.initials: M
authors.lastname: Pahwa
authors.forename: Archna R
authors.initials: AR
authors.lastname: Pahwa
authors.forename: Mohit
authors.initials: M
authors.lastname: Girotra
authors.forename: Arun
authors.initials: A
authors.lastname: Chawla
authors.forename: Ajay
authors.initials: A
authors.lastname: Sharma
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D017060:Patient Satisfaction; D018579:Patient Selection; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D017430:Prostate-Specific Antigen