title: Prostate-specific antigen evolution after photoselective vaporization of the prostate.
abstract: BACKGROUND
  Prostate-specific antigen (PSA) variations after photoselective vaporization of the prostate are an unsolved question.
  
  
  METHODS
  We included prospectively 323 patients who underwent GreenLight® prostate vaporization for prostatic hyperplasia between 2005 and 2013. We excluded patients with prostate cancer and those with concomitant prostate biopsies. Serum PSA levels were measured before and after the procedure at 1, 6, 12, 24, 36, and 48 months.
  
  
  RESULTS
  The median preoperative PSA level was 4.50 ng/mL; it decreased to 2.41 ng/mL at 1 month (47% reduction), 2.17 ng/mL at 6 months (52% reduction), 2.30 ng/mL at 1 year (49% reduction), 2.40 ng/mL at 2 years (47% reduction), 2.31 ng/mL at 3 years (49% reduction), and 2.54 ng/mL at 4 years (44% reduction) (P values were all <0.0001). The median PSA nadir at 6 months was significantly different from the median PSA level at 1, 2, 3, and 4 years (respectively P=0.0046, P=0.0017, P=0.0006, and P=0.01). Patients who received ≤3000 J/cc had a significant trend to a PSA reascension after 6 months. Patients who received ≥4000 J/cc did not show any significant PSA reascension during the 4 years after procedure. Energy was correlated with the PSA reascension in univariate and multivariate analysis.
  
  
  CONCLUSIONS
  The PSA level significantly decreased by half 1 month after the procedure, reached its nadir at 6 months, and showed a slight progressive reascension during the 4 following years. Applying an energy rate ≥4000 J/cc of prostate induced PSA stability over time whereas energy ≤3000 J/cc induced a reascension of the PSA level after 6 months.
authors.affiliation: 1 Urology Department, University Hospital of Angers , Angers, France .
authors.forename: Souhil
authors.initials: S
authors.lastname: Lebdai
authors.forename: Yohann
authors.initials: Y
authors.lastname: Prezelin
authors.forename: Helder
authors.initials: H
authors.lastname: Pereira
authors.forename: Franck
authors.initials: F
authors.lastname: Bruyere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000473:pathology / Q000601:surgery*; D014835:Volatilization
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen