Abstract

"Purpose: We investigated the prostatic cancer rate according to patterns of PSA after antibiotics medication. Materials and Methods: Ninety-five patients with lower urinary tract symptoms (LUTS) and pyuria were treated with quinolone. Pyuria defined as more than 5 WBC/HPF in expressed prostatic secretion or VB3. We evaluated serum PSA level before and after antibiotic treatment and prostatic biopsy results in patients without decreased PSA under 4ng/ml. We compared prostatic cancer rate between 23 patients with decreasing PSA but above 4ng/ml (group A) and 22 patients without decreasing PSA than premedication (group B). Results: Of the 96 patients, 51 patients (53.1%) demonstrated serum PSA decreased lower than 4ng/ml. The remaining 45 patients were underwent prostate biopsy and prostatic cancer was found in 6 patients. Mean age and mean prostate volume in group A and group B were 61.4±12.7years, 61.9±10.4years (p=0.702) and 32.0±8.7gm, 31.7±5.6gm (p=0.532), respectively. Mean serum PSA before and after treatment were 7.84±2.97 ng/ml, 8.05±3.62ng/ml (p=0.246) and 4.53±2.33ng/ml, 8.55±3.25 (p=0.042) in group A and B, respectively. Positive predictive value for prostatic cancer increased from 0.063 to 0.133 in pretreatment and posttreatment patients (p=0.644) and from 0.043 to 0.227 in group A and B, respectively (p=0.039). Conclustions: Antibiotic treatment can decrease the serum PSA for chronic prostatitis and improve positive predictive value for prostatic cancer. Therefore we should consider prostate biopsy in patient without decreasing PSA after antibiotic medication."

• Keywords: Prostatitis, Prostatic cancer, Prostate-specific antigen