The Journal of Urology
Volume 183, Issue 3 , Pages 940-945 , March 2010

Prostate Specific Antigen Decrease and Prostate Cancer Diagnosis: Antibiotic Versus Placebo Prospective Randomized Clinical Trial

Presented at annual meeting of American Urological Association, Chicago, Illinois, April 25–30, 2009.

Received 20 July 2009

References 

  1. Krieger JN, Nyberg L, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA. 1999;282:236
  2. Nickel JC, Nyberg LM, Hennenfent M. Research guidelines for chronic prostatitis: consensus report from the first National Institutes of Health International Prostatitis Collaborative Network. Urology. 1999;54:229
  3. Potts JM. Prospective identification of National Institutes of Health category IV prostatitis in men with elevated prostate specific antigen. J Urol. 2000;164:1550
  4. Terrone C, Poggio M, Bollito E, et al. Asymptomatic prostatitis: a frequent cause of raising PSA. Recenti Prog Med. 2005;96:365
  5. Delongchamps NB, de la Roza G, Chandan V, et al. Evaluation of prostatitis in autopsied prostates–is chronic inflammation more associated with benign hyperplasia or cancer?. J Urol. 2008;179:1736
  6. Loeb S, Gashti SN, Catalona WJ. Exclusion of inflammation in the differential diagnosis of an elevated prostate-specific antigen (PSA). Urol Oncol. 2009;27:64
  7. Mears EM, Stamey TA. Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol. 1968;5:492
  8. Scardino PT. The responsible use of antibiotics for an elevated PSA level. Nat Clin Pract Urol. 2007;4:1
  9. Kaygisiz O, Ugurlu O, Koşan M, et al. Effects of antibacterial therapy on PSA change in the presence and absence of prostatic inflammation in patients with PSA levels between 4 and 10 ng/ml. Prostate Cancer Prostatic Dis. 2006;9:235
  10. Tchetgen MB, Oesterling JE. The effect of prostatitis, urinary retention, ejaculation, and ambulation on the serum prostate-specific antigen concentration. Urol Clin North Am. 1997;24:283
  11. Habermacher GM, Chason JT, Schaeffer AJ. Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 2006;57:195
  12. Zhang L, Loblaw A, Klotz L. Modeling prostate specific antigen kinetics in patients on active surveillance. J Urol. 2006;176:1392
  13. Komatsu K, Wehner N, Prestigiacomo AF, et al. Physiologic (intraindividual) variation of serum prostate-specific antigen in 814 men from a screening population. Urology. 1996;47:343
  14. Nadler RB, Humphrey PA, Smith DS, et al. Effect of inflammation and benign prostatic hyperplasia on elevated serum prostate specific antigen levels. J Urol. 1995;154:407
  15. Stancik I, Luftenegger W, Klimpfinger M, et al. Effect of NIH-IV prostatitis on free and free-to-total PSA. Eur Urol. 2004;46:760
  16. Shimomura T, Kiyota H, Takahashi H, et al. Prostate histopathology of NIH category IV prostatitis detected by sextant prostate needle biopsy from the patients with high prostatic specific antigen. Kansenshogaku Zasshi. 2003;77:611
  17. Gümüş BH, Neşe N, Gündüz MI, et al. Does asymptomatic inflammation increase PSA? (A histopathological study comparing benign and malignant tissue biopsy specimens). Int Urol Nephrol. 2004;36:549
  18. Simardi LH, Tobias-Machado M, Kappaz GT, et al. Influence of asymptomatic histologic prostatitis on serum prostate-specific antigen: a prospective study. Urology. 2004;64:1098
  19. Bozeman CB, Carver BS, Eastham JA, et al. Treatment of chronic prostatitis lowers serum prostate specific antigen. J Urol. 2002;167:1723
  20. Guercio S, Terrone C, Tarabuzzi R, et al. PSA decrease after levofloxacin therapy in patients with histological prostatitis. Arch Ital Urol Androl. 2004;76:154
  21. Serretta V, Catanese A, Daricello G, et al. PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients. Prostate Cancer Prostatic Dis. 2008;11:148
  22. Karazanashvili G, Managadze L. Prostate-specific antigen (PSA) value change after antibacterial therapy of prostate inflammation, as a diagnostic method for prostate cancer screening in cases of PSA value within 4-10 ng/ml and nonsuspicious results of digital rectal examination. Eur Urol. 2001;39:538
  23. Erol H, Beder N, Caliskan T, et al. Can the effect of antibiotherapy and anti-inflammatory therapy on serum PSA levels discriminate between benign and malign prostatic pathologies?. Urol Int. 2006;76:20
  24. Kobayashi M, Nukui A, Morita T. Serum PSA and percent free PSA value changes after antibiotic treatment (A diagnostic method in prostate cancer suspects with asymptomatic prostatitis). Urol Int. 2008;80:186
  25. Baltacı S, Süer E, Haliloglu AH, et al. Effectiveness of antibiotics given to asymptomatic men for an increased prostate specific antigen. J Urol. 2009;181:128
  26. Thompson IM, Pauler DK, Goodman PJ, et al. Prevalence of prostate cancer among men with a prostate-specific antigen level < 4.0 ng per milliliter. N Engl J Med. 2004;350:2239

 Nothing to disclose.

 Study received institutional review board approval.

 Editor's Note: This article is the third of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1262 and 1263.

PII: S0022-5347(09)02935-8

doi: 10.1016/j.juro.2009.11.044

The Journal of Urology
Volume 183, Issue 3 , Pages 940-945 , March 2010