The Change of Prostate Specific Antigen after Treatment in Chronic Prostatitis Associated with Elevated Serum Prostate Specific Antigen

Cheong, Joo Yeol; Cheon, Sang Hyeon; Park, Ro Jung; Oh, Chang Soo; Kim, Jung Hyun

Abstract

PURPOSE: Men with documented chronic prostatitis, with elevated serum prostate specific antigen (PSA), were investigated to assess whether treatment lowers serum PSA and thus avoids unnecessary biopsies.
MATERIALS AND METHODS
The medical records of 46 men who presented with serum PSA higher than 4ng/ml, and subsequently diagnosed with chronic prostatitis, were retrospectively reviewed. After the administration of antibiotics and anti-inflammatory drugs for 4 to 8 weeks, the follow-up PSA levels were determined, and those with levels higher than 4ng/ml underwent a prostate biopsy.
RESULTS
The mean PSA level decreased 61% from 11.66ng/ml before, to 3.79ng/ml after, treatment (p<0.001). In 30 patients the serum PSA level decreased to below 4ng/ml (mean 1.69), with these patients no longer having an indication for a prostate biopsy. In the remaining 16 patients the serum PSA level remained elevated above 4ng/ml, so they underwent a prostate biopsy. Pathological study revealed benign prostatic hyperplasia in 11 cases and prostate cancer in 5. The PSA level in patients associated with benign prostatic hyperplasia decreased 61.9% with treatment, from 19.96 to 7.88ng/ml (p=0.006) and the PSA in those associated with prostate cancer decreased 30.6% with treatment, from 12.85 to 7.32ng/ml (p<0.05).
CONCLUSIONS
This study demonstrates that chronic prostatitis can cause elevation of serum PSA levels, and when identified, antibiotics and anti-inflammatory treatment can lower these levels and an unnecessary prostate biopsy can be avoided.