scholarly journals The Modulating Effects of Benign Prostate Enlargement Medications on Upgrading Predictors in Patients with Gleason 6 at Biopsy

2016 ◽  
Vol 10 (2) ◽  
pp. 97-104
Author(s):  
Seyed Behzad Jazayeri ◽  
Young S. Kwon ◽  
Russell McBride ◽  
Michael Leapman ◽  
Shemille Collingwood ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Specific Antigen ◽  
Clinical Predictors ◽  
Medication History ◽  
Alpha Blockers ◽  
Reductase Inhibitors ◽  
Prostate Size ◽  
History Of ◽  
Biopsy Gleason Score

Background: Upgrading following prostate biopsy is very common in clinical practice. This study investigated whether the use of 5-alpha reductase inhibitors (ARI) and alpha blockers affect known clinical predictors of Gleason score upgrading or not. Materials and Methods: A retrospective study on 998 patients treated with robotic assisted laparoscopic prostatectomy for clinically localized biopsy Gleason score 6 prostate cancer were studied. The logarithm of prostate specific antigen concentration, prostate size and tumor volume were compared on the basis of the medication history of 5-ARIs and alpha blockers in the cohort of biopsy Gleason 6 patients with benign prostatic hyperplasia history, and patients whose prostate sizes fall in the top quartile. We compared known clinical and pathologic characteristics associated with upgrading in regression models with and without the addition of medications. Results: Alpha blockers, but not 5-ARI were associated with a bigger prostate. Upgrading was associated with older age (OR 1.03, 95% CI 1.01-1.06), higher BMI (OR 1.00 CI 1.01-1.08), higher log prostate specific antigen (OR 7.32, CI 3.546-15.52), smaller prostate size (OR 0.97, CI 0.96-0.98), fewer biopsy cores (OR 0.96 CI 0.92-0.99), more positive cores (OR 1.20, CI 1.08-1.34), and higher percentage of tumor at biopsy (OR 1.02, CI 1.01-1.03). Neither of the two medication classes were a significant predictor of upgrading. Medications made minimal changes in the multivariate predictive models. Conclusion: Although, alpha blockers were associate with bigger prostate size, the modulating effects of alpha blockers and 5-ARIs on common predictors of Gleason score upgrading was not significant.

scholarly journals The Effect of Ofloxacin in Men With Elevated Prostate Specific Antigen

2021 ◽  
Author(s):  
Seyedhossein Rabani ◽  
Ali Mousavizadeh ◽  
Seyed Mohammadreza Rabani
Keyword(s):  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Elevated Serum ◽  
Significant Drop ◽  
Prostate Hyperplasia ◽  
Reductase Inhibitors ◽  
History Of ◽  
Benign Prostate ◽  
5 Alpha Reductase Inhibitors

Abstract Background: Antibiotic prescription is a common practice in men with elevated serum prostate specific antigen. The thought is that if patients were to have a drop in, or normalization of their PSA, we can be able to avoid unnecessary prostate biopsy. The aim of this study was to evaluate the effect of ofloxacin in men with elevated PSA.Methods: 224 men with elevated PSA from the base of 4 ng/ml were enrolled in this study. Exclusion criteria were age less than 50 or greater than 75, history of allergy to fluoroquinolones, cases with history of recent prostate manipulation, men on 5 alpha reductase inhibitors, and known cases of prostate cancer. After a duration of 10 days ofloxacin 200 mg twice a day orally, PSA level was rechecked.Results: Mean age was 61.18 year. Mean PSA level before administering antibiotic was 26.3 ng/ml (-21.9 +97.4). In 120 patients (53.57%) a significant drop in serum PSA was detected so prostate biopsy was not done and in the remainder 104 patients (46.43%), Prostate biopsy was done that showed 65 adenocarcinomas of prostate and 39 benign prostate hyperplasia. Conclusions: This study showed in a patient with active urinalysis (pyuria) and normal rectal examination, trans rectal ultrasonography and prostate biopsy should be post ponded and antibiotic be started. If significant drop in serum PSA was seen, antibiotic should be continued to avoid unnecessary biopsies, otherwise, no benefit in asymptomatic men with normal urinalysis, but elevated PSA.

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