Objective: To investigate the impact of prostatitis on serum
prostate-specific antigen (PSA) level in patients with benign
prostatic hyperplasia (BPH).
Methods: A total of 15 BPH patients with prostatitis who
were treated in our department from January 2006 to January
2011 were enrolled in this study. These patients, aged 54-
86 years (mean: 66 years), had lower urinary tract symptoms
(LUTS). LUTS was aggravated in 12 patients, among whom 10
experienced acute retention of urine and 3 were hospitalized due
to increased serum PSA levels. Of these 15 patients, the IPSS
scores ranged 22-28 (mean ± SD: 26±3.22). The prostate showed
moderate hyperplasia in 14 patients and severe hyperplasia in 1
patient. THe serum PSA levels ranged 22.4-156.8 ng/mL in four
patients (mean ± SD: 82.4±22.2 ng/mL). Ten patients received
routine prostatic fluid test, whihc illustrated the presence of
white blood cell findings (+-+++). Five patients with acute
prostatitis who did not receive prostate massage experienced
increased haemogram, fever, and perineal pain. All the 15
patients underwent prostate biopsy and were diagnosed as BPH
and prostatitis, while no prostate cancer was identified. Twelve
patients underwent surgical treatment and 3 received expectant
Results: Pre-operative biopsy was performed for all patients.
Although the serum PSA level increased among these patients,
prostate cancer was not screened. The pre-operative serum PSA
was decreased after anti-bacterial treatment. Twelve patients
received surgical treatment, and the post-operative pathology
confirmed the diagnosis of BPH and prostatitis. Three patients
underwent expectant treatment after anti-bacterial treatment,
and their PSA gradually returned normal.
Conclusions: BPH with prostatitis can damage the glandular
epithelium and thus destroy the barrier formed by basal cells;
as a result, the leakage of PSA increases the serum PSA level.
Proper anti-bacterial therapy can effectively lower PSA value and
improve LUTS. For BPH patients with prostatitis and increased
PSA, anti-bacterial therapies may be applied. Meanwhile, PSA
may be followed up; if PSA decreases, prostate biopsy and/or
surgery can be postponed.