ABSTRACT

We evaluated the effect of TUR(P) on PSA progression in patients with advanced prostate carcinoma and urinary retention.

We studied on 17 patients with advanced prostate cancer who had urinary retention when followed with hormonal treatment. Their mean age was 74.85 years. The patient files were noted such as rectal examination, bone scintigraphy, USG, treatment, prostate biopsy results, initial PSA and PSA measurements every during treatment. All of these patients were performed Channel TUR(P). After TUR(P), the patients were followed by PSA measurements at the first month and then every two months. We determined the patients with PSA progression and statistically analysed our results during the follow up.

After Channel TUR(P) within six month, six patients had PSA progression and 2 of the patients died due to disease progression. At the end of the first year, the progression of PSA was assessed in 9 patients and 3 patients died as well. There was no statistical difference between both groups with or without PSA progression. In addition, the difference between Gleason score employed in prostate needle biopsy and PSA progression were not statistical different. When Channel TUR(P) specimens were compared with the outcomes of prostate needle biopsy in histologic manner, upgrading were determined in 10 cases. Statistical difference was significant in patients who were determined high grade and PSA progression (p<0.05).

As a result, we thought that urinary retention in advanced prostate cancer might be caused by grade progression and this was related to increased prostate size. We found that Channel TUR(P) which was performed on these patients had no effect on PSA progression.