[Preoperative PSA levels and development of PSA after 180-W XPS greenlight laser treatment of the prostate: what is the reality in clinical routine practice?] / Präoperative PSA-Werte und PSA-Verlauf nach 180-Watt-XPS-Greenlight-Laserung der Prostata wie ist die Realität im klinischen Alltag?
Aktuelle Urol
; 51(1): 53-58, 2020 Feb.
Article
em De
| MEDLINE
| ID: mdl-32018334
ABSTRACT
INTRODUCTION:
The aim of this retrospective study was to evaluate preoperative levels of PSA (prostate-specific antigen) and the postoperative development after 180-W XPS™ greenlight laser treatment of the prostate under real-world conditions.METHOD:
Preoperative PSA levels were evaluated in 749 patients undergoing a 180-W XPS greenlight laser procedure from 2012 to 2017 in Witten, Germany, in relation to age, volume of the prostate, urinary tract infection, Foley catheter and co-morbidities. The postoperative development of PSA was identified by retrieving PSA levels from general practitioners or urologists.RESULTS:
The average age of the patients was 73.33â±â9.26 years. The prostate volume measured by rectal ultrasound was 42.42â±â18.33âml. Median preoperative PSA was 2.59âng/ml. In 268 patients (35.8â%), the PSA level was above 4âng/ml. It was evaluated by prostate biopsy in 106 patients (39.6â%). 6 months after the surgical procedure (nâ=â86), PSA decreased to 1.25âng/ml and increased slightly to 1.46âng/ml after 12 months (nâ=â126). Logistic regression analysis demonstrated that a PSA level elevated to more than 4âng/ml preoperatively is related to prostate volume (pâ=â0.001) the existence of a transurethral Foley catheter (pâ=â0.002), but not to age (pâ=â0.349), the existence of a suprapubic catheter (pâ=â0.207), an infection of the lower urinary tract (pâ=â0.966) and the number of co-morbidities mentioned in the discharge letter (pâ=â0.936).DISCUSSION:
In line with expectations and clinical trials, there was a postoperative decrease of PSA by more than a half of the preoperative value. Significant factors related to preoperative elevation of the PSA level were prostate volume, a transurethral Foley catheter instead of the suprapubic type of catheter and a urinary infection. Although elevated PSA levels were seen in about one third of patients, evaluation by prostate biopsy was only performed in 39.6â% of these patients due to their performance status and other clinical issues.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Doenças Prostáticas
/
Antígeno Prostático Específico
/
Terapia a Laser
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
De
Revista:
Aktuelle Urol
Ano de publicação:
2020
Tipo de documento:
Article