Transvezikal prostatektomi ve transuretral prostatektomi uygulanan hastalarda çıkarılan doku miktarı ile PSA düşüşü arasıındaki ilişki

Abstract

Amaç: Transvezikal prostatektomi (TVP) ve transuretral prostatektomi (TURP)' de çıkartılan doku miktarlarıyla PSA düzeylerindeki düşüş arasındaki ilişkinin incelenmeyi amaçladık . Gereç ve yöntem: Patoloji sonuçları adenomyomatoz hiperplazi gelen TVP yapılan 79 hasta ve TUR-P yapılan 135 hasta çalışmaya dahil edildi. Hastaların ortalama yaşı TVP grubunda 68.2, TURP grubunda 65.7 idi. Tüm hastalara operasyon öncesi PRM, serumda total ve serbest PSA, TRUS, üroflovmetre ve IPSS yapıldı. Postoperatif 3. ayda PSA tekrar ölçüldü ve total ve serbest PSA değerlerindeki azalma ile rezeke edilen doku miktarı arasındaki korelasyon araştırıldı. Bulgular: TVP de prostat dokusunun % 81.4' ü çıkarılarak total PSA da % 79, serbest PSA da %58 düşüş saptanırken; TURP grubunda prostat dokusunun %52' si çıkarılarak total PSA da %47, serbest PSA da %42'lik bir düşüş izlenmiştir (p<0.001). Rezeke edilen 1 gr prostat kütlesine karşılık TVP grubunda total PSA' da 0.145 ng/ml, serbest PSA' da 0.03 ng/ml azalma; TURP grubunda total PSA' da 0.103 ng/ml, serbest PSA' da 0.013 ng/ml azalma bulundu. Sonuç: BPH nedeniyle TURP yapılan hastalarda, çıkartılan doku miktarına paralel olarak total ve serbest PSA değerlerinde azalma olur.Objective: To investigate the correlation between extracted tissue amount and prostate specific antigen (PSA) decline in patients treated with transvesical prostatectomy (TVP) and transurethral resection of prostate (TURP). Methods: A total of 79 patients who underwent TVP and 135 patients who underwent TUR-P with histopathologically, diagnosis of BPH was confirmed were enrolled to the study. The mean age of patients was 68.2 years in TVP group and 65.7 years in TURP group. All patients had DRE, serum total and free PSA, TRUS, uroflowmeter, and IPSS before the operation. In the postoperative 3rd month, the PSA measurement was repeated, and the correlation between the decrease in total and free PSA levels and the amount of tissue resected during the procedure was investigated. Results: In TVP group mean enucleated prostate volume was 81.4%. The decrease in total and free PSA levels was 79% and 58%, respectively. In TURP group mean resected prostate volume was 52%. The decrease in total and free PSA levels was 47% and 42%, respectively (p&lt;0.001). For 1 g of prostate mass enucleated in TVP group, the total and free PSA levels decreased 0.145 ng/ml and 0.03 ng/ml, respectively. In TURP group for 1 g of prostate mass resected, the total and free PSA levels decreased 0.103 ng/ml and 0.013 ng/ml, respectively. Conclusion: Total-free PSA levels decrease with the amount of tissue extracted during TURP in BPH patients.