title: [Comparison in the follow-up of two patients with persistent elevated PSA and negative prostate biopsy].
abstract: OBJECTIVE
  To compare two clinical cases on the follow-up of patients with benign prostatic hyperplasia at risck of progression, negative prostate biopsy and persistent elevated PSA levels.
  
  
  METHODS
  After a first negative prostate biopsy for elevated PSA levels, Case A received dutasteride therapy for benign prostatic hyperplasia, whereas Case B continued his therapy without dutasteride. In both cases, other diagnostic procedures or other biopsies were decided on the basis of PSA level modifications.
  
  
  RESULTS
  Case A showed a stabilization of PSA levels with a new nadir; the patient did not undergo new biopsies or other diagnostic procedures till the presence (24 months of follow-up) of a PSA elevation despite dutasteride therapy. A new biopsy, then, showed a prostate adenocarcinoma. Case B showed persistent and progressive PSA elevation; the patient underwent other diagnostic procedures and 2 new negative biopsies. Only after 26 months of follow-up a further biopsy showed a prostate adenocarcinoma.
  
  
  CONCLUSIONS
  5-alpha-reductase inhibitors can reduce the number of unnecessary prostate biopsies.
authors.affiliation: Dipartimento di Urologia, Universita' Sapienza di Roma, Roma - Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sciarra
authors.forename: Valeria
authors.initials: V
authors.lastname: Panebianco
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology*; D001378:Azasteroids / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D000068538:Dutasteride; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D012680:Sensitivity and Specificity
chemical_list: D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen; D000068538:Dutasteride