The Effect of Acute Urinary Retention on The Accuracy of Serum Prostate-Specific Antigen Level Measurements
Iraqi Postgraduate Medical Journal,
2012, Volume 11, Issue 1, Pages 118-122
The level of PSA in serum is increased by inflammation of the prostate, urinary retention,prostatic
infection, benign prostatic hyperplasia,prostate cancer, and prostatic manipulation. 
To study the effect of acute urinary retention on the serum prostate-specific antigen (PSA)
Blood samples for serum PSA measurement were obtained (PSA1), and an indwelling urethral
catheter was inserted for 2 weeks. Before catheter removal, a second blood sample for measurement
of serum PSA level (PSA2) was obtained. In patients who were able to void, a third sample was
obtained 3 weeks later (PSA3). In the first and second visits, digital rectal examinations (DRE1,
DRE2) were performed to assess prostate volume. Mean PSA levels (PSA1, PSA2, and PSA3) and
prostate volumes (DRE1, DRE2) were compared.
Fourty-two patients with a mean age of 70.18 years (range 56 to 85 years) participated in this
study.mean PSA level at the time of AUR (PSA1) was 7.02 ng/mL (median, 5.8 ng/mL; range, 0.9 to
30.4 ng/mL). The mean PSA2 level was 5.5 ng/mL (median, 3.9 ng/mL; range, 0.7 to 39 ng/mL),
lower than the PSA1 level .This association was statistically non significant P > 0.05. The mean
prostate volume at the time of DRE1 (43.4 mL; median, 45 mL; range, 30 to 60 mL) was
significantly higher than at DRE2 (37.8 mL; median, 40 mL; range, 25 to 50 mL) (P < 0.001).
PSA3 was measured in 42 patients 4 weeks after retention (2 weeks after catheter removal). In this
group of patients, mean PSA2 and PSA3 levels were 5.5 ng/mL and 5.1 ng/mL, respectively (median,
3.9 and 3.5, respectively, P > 0.05).
Acute urinary retention can increase serum PSA levels. In this series, we found that this effect may
continue up to 2 weeks.
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