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Routine Estimation of Prostate Specific Antigen Prior to Clinic Attendance in Patients with Symptoms of Bladder Outlet Obstruction
Author(s) -
VISWANATH S.,
PALMER M. A.,
OJHA H. O.,
DESMOND A. D.
Publication year - 1993
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1993.tb00685.x
Subject(s) - medicine , urology , prostate specific antigen , bladder outlet obstruction , prostate cancer , prostate , biopsy , carcinoma , cancer
Summary— We report the use of serum prostate specific antigen (PSA) estimations prior to clinic attendance in 234 patients referred with symptoms of bladder outlet obstruction to a general urology clinic. Ninety‐three patients with PSA levels > 10 ng/ml were seen earlier than planned and offered transurethral resection or transrectal biopsy of the prostate gland. Forty‐six patients (49%) proved to have carcinoma of the prostate, compared with 10 of 141 (7%) patients who had PSA values < 10 ng/ml. With a decision value of 10 ng/ml, the sensitivity for detecting carcinoma was 82% and specificity 73.5%. Using a decision value of 7 ng/ml improved the sensitivity to 95% without significantly affecting the specificity (70%). Twenty‐four patients with prostatic cancer had bone metastases; the sensitivity of PSA for predicting a positive bone scan using a decision value of 25 ng/ml was 92%, but the specificity was only 31%.