serum prostate specific antigen
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Author(s):  
Osamu Yokoyama ◽  
Masashi Honda ◽  
Tomonori Yamanishi ◽  
Yuki Sekiguchi ◽  
Kenji Fujii ◽  
...  

Abstract Purpose We aimed to assess onabotulinumtoxinA treatment outcomes by sex in patients with overactive bladder (OAB) and then explore the impact of serum prostate-specific antigen (PSA) levels in men. Methods Patients inadequately managed with OAB medications were randomized to receive single-dose onabotulinumtoxinA (100 U) or placebo intravesical injection in a phase III trial in Japan. We performed subgroup analyses by sex and post-hoc subgroup analyses using male PSA categories. Results In women (n = 186), onabotulinumtoxinA demonstrated statistically significant and clinically relevant improvements in all urinary symptoms at Week 12. In men with lower PSA (< 1.5 ng/mL, n = 40), onabotulinumtoxinA also showed numerically greater reductions in urinary symptom frequency than placebo; the between-group differences (onabotulinumtoxinA minus placebo) in change from baseline in the average daily number at Week 12 for urinary incontinence (UI), urgency UI, micturition, urgency, and nocturia were − 1.43, − 1.79, − 2.81, − 2.45, and − 0.32 episodes, respectively. In men with higher PSA (≥ 1.5 ng/mL, n = 22), onabotulinumtoxinA did not reduce urinary symptom frequency. Some patients treated with onabotulinumtoxinA showed elevated post-void residual urine volume at Week 2 (≥ 200 mL): 4 of 91 women, none of the men with lower PSA and 3 of 11 men with higher PSA. Conclusions OnabotulinumtoxinA was efficacious and well tolerated in women and in men with lower PSA levels. Given our post-hoc subgroup analyses which suggested that onabotulinumtoxinA treatment is a good treatment option for OAB males with lower PSA levels, future studies having prostate volume data with larger sample size are warranted to verify our findings. ClinicalTrials.gov Identifier NCT02820844 (first posted July 1, 2016). https://clinicaltrials.gov/ct2/show/NCT02820844.


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Maxwell Okuja ◽  
Faith Ameda ◽  
Henry Dabanja ◽  
Felix Bongomin ◽  
Samuel Bugeza

Abstract Background Prostate disorders are among the leading causes of morbidity and mortality in men above the age of 40 years globally. Serum prostate-specific antigen (PSA) levels may be used to screen men at risk of prostate cancer and determine choice of medical treatment in benign prostatic hyperplasia (BPH) and evaluation of patients with prostatitis, while prostate sonography determines prostate volume (PV) and detects nodules. BPH may exhibit distinct hypoechoic, isoechoic, or hyperechoic nodules in the transition zone, whereas hypoechoic nodules in the peripheral zone are diagnostic for prostate cancer in over 50% of cases. In this study, we aimed at determining the relationship between serum PSA levels and transrectal prostate sonographic findings among asymptomatic Ugandan males. Methods Ugandan males above 30 years of age or older without lower urinary tract symptoms were cross-sectionally enrolled into the study. Serum PSA determination and transrectal ultrasound were performed. Association between PSA levels and PV was assessed using Spearman’s correlation coefficients (ρ). Results A total of 277 men were studied. The median serum PSA level was 1 (95% CI: 1–2). Most (n = 217, 78.3%) participants had serum PSA levels ≤ 4 ng/ml. The median sonographic PV was 26 (95% CI: 26–29) mls. One hundred and fifty-five (56.0%) participants had PV between 25 and 50 mls. Both PSA levels and PV progressively increased with age from 0.9 ng/ml and 22 mls in the 30–39 year age group to 7 ng/ml and 38 mls in the 60–69 year age group, respectively. PSA levels weakly correlated with PV (ρ = 0.27) (p < 0.0001). One hundred and thirty (47%) participants had prostatic nodules. Of these, 100 (77%) had features of benign nodules and 23% had suspicious nodules for prostate cancer. The median (range) serum PSA level in those with nodules was 2.0 (0.1–16.0) ng/ml and for those without nodules was 1.1 (0.1–8.0) ng/ml (p < 0.0001). Conclusions Serum PSA has a weak direct correlation with PV and not a reliable marker for the prediction of presence or absence of prostatic nodules in asymptomatic adult males.


2021 ◽  
Vol 11 (1) ◽  
pp. 1859-1863
Author(s):  
Priyanka Sangappa Murgod ◽  
Preeti Rajeev Doshi ◽  
Amit Ravindra Nisal ◽  
Ravindra Chandrashekar Nimbargi

Background: The prostate is a walnut-sized organ that surrounds the urethra. More than 99% of prostate cancers are prostatic adenocarcinoma. It is the second most commonly occurring cancer in men and the fourth most commonly occurring cancer in India and all over the world. Numerous lesion of the prostate are very similar to prostate cancer, hence awareness is very important. This study aimed to determine the histopathological features of prostate adenocarcinoma and its common mimickers.Materials and Methods: A retrospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology for a period of one year. A brief clinical history and serum prostate-specific antigen levels were noted.Results: The surgical specimens of 303 cases of prostatic diseases were studied. Benign prostatic hyperplasia was the most frequent diagnosis in 192 patients followed by Prostate adenocarcinoma seen in 80 patients. Prostatic intraepithelial neoplasia formed the predominant mimicker (5.9%), followed by basal cell hyperplasia (3.0%). Serum prostate-specific antigen was seen in the range of 1.73 - 100 ng/ml in the cases of adenocarcinoma. In the mimics, prostate-specific antigen was in the range of 1.2- 18ng/ml.Conclusions: Biopsy remains a gold standard for the diagnosis of adenocarcinoma and its mimickers. The lesions in this study were diagnosed on hematoxylin and eosin staining.


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