Talic R F, El-Tiraifi A M, Altaf S, Hargreave T B
Department of Surgery, College of Medicine & King Khalid University Hospital, Riyadh, Saudi Arabia.
Int Urol Nephrol. 2000;32(2):271-4. doi: 10.1023/a:1007170029017.
We evaluated the effect of the high electrocuting energy used with the thick loop, in transurethral vaporization resection of the prostate (TUVRP), on serum prostate-specific antigen (PSA). Forty-eight patients with benign protatic hyperplasia (BPH) were included in this prospective single arm sequential study. All patients had TUVRP using the 'Wing' thick resection electrode (Richard Wolf, Germany). Serum PSA was measured before, 1 day and 6 weeks in the morning post TUVRP. PSA values were correlated to preoperative prostate size and to prostatic resection weight. Serum PSA values (mean +/- SD) were 6.29+/-4.4 ng/ml, 14.9+/-11.1 and 2.3+/-1.9 before, 1 day and 6 weeks post TUVRP respectively. The mean increase in the PSA at 1 day over baseline value was 2.72, this was statistically significant (p < or = 0.0001). The PSA level returned to less than pre TUVRP value in all but 3 patients by 6 weeks. The PSA value 1 day post TUVRP correlated well with the pre PSA level, prostate size and prostatic resection weight (r = 0.58, r = 0.38 and r = 0.44 respectively) however, the PSA level at 6 weeks correlated only to pre TUVRP values (r = 0.53). We conclude that that serum PSA is not reliable within 6 weeks of TUVRP. The reversible increase in serum PSA value is similar to other forms of prostatectomy which, suggests that the increased level of electrosurgical energy that is used in TUVRP does not have an added adverse effect on the PSA levels.
我们评估了在经尿道前列腺汽化切除术（TUVRP）中使用粗线圈的高电切能量对血清前列腺特异性抗原（PSA）的影响。本前瞻性单臂序贯研究纳入了48例良性前列腺增生（BPH）患者。所有患者均使用“Wing”粗切除电极（德国理查德·沃尔夫公司）进行TUVRP。在TUVRP术前、术后1天及术后6周早晨测量血清PSA。PSA值与术前前列腺大小及前列腺切除重量相关。TUVRP术前、术后1天及术后6周的血清PSA值（均值±标准差）分别为6.29±4.4 ng/ml、14.9±11.1 ng/ml和2.3±1.9 ng/ml。术后1天PSA较基线值的平均升高为2.72，具有统计学意义（p≤0.0001）。除3例患者外，所有患者的PSA水平在6周时恢复至低于TUVRP术前值。TUVRP术后1天的PSA值与术前PSA水平、前列腺大小及前列腺切除重量相关性良好（r分别为0.58、0.38和0.44），然而，术后6周的PSA水平仅与TUVRP术前值相关（r = 0.53）。我们得出结论，TUVRP术后6周内血清PSA不可靠。血清PSA值的可逆性升高与其他形式的前列腺切除术相似，这表明TUVRP中使用的较高电外科能量对PSA水平没有额外的不良影响。
