AI Summary & Key Takeaways
AI InsightWe believe that to avoid false interpretation, total and free PSA measurements should precede these procedures if they have to be obtained on the same day.
📌 3 Key Takeaways
Abstract
Introduction: Manipulations of the prostate gland that may cause rupture of the basement membrane have the potential of causing elevated PSA levels. After the raised question of whether the transrectal manipulation of a large colonoscope for more than 30 minutes may affect serum PSA levels, Schwartz et al. in their previously reported study in which PSA measurements 24 hours, 7 days and 30 days after colonoscopy were compared with the PSA levels 24-72 hours before the procedure, have stated that colonoscopy has no adverse effect on serum total PSA levels. To examine the issue further, we conducted the present prospective study on the diurnal early effects of colonoscopy and a shorter procedure rectoscopy, on serum total, free and free/total prostate specific antigen (PSA) levels. Materials and Methods: Forty-seven consecutive men in whom flexible colonoscopy or rectoscopy was to be performed enrolled in the study. Twenty-eight of the patients undervvent colonoscopy and 19 patients underwent rectoscopy. Serum total and free PSA levels were measured immediately before and 2 hours after the procedures. The signifıcance of differences between total, free and free/total PSA values obtained before and after the procedures, any possible correlation with procedure time ör age with PSA increases was analyzed by the paired t test. Results: Statistically signifıcant increases vvere observed between pre-examination and post-examination total and free PSA values after colonoscopy and rectoscopy (p<0.001). Duration of the procedure and age had no Statistically signifıcant effect on total or free PSA values (p>0.05). Serum total PSA increases vvere encountered in 89% of the patients in the colonoscopy group and 95% in the rectoscopy group. in the colonoscopy group, total PSA increased from 0.89+0.73 ng/mL to 2.54±1.88 ng/mL (p=0.001). in the rectoscopy group, total PSA increased from 0.96±0.58 to 2.87+1.74 ng/mL. in 17 patients (37%), the post-procedure total PSA value was above 4 ng/mL. in 14 (50%) of the patients who underwent colonoscopy and in 11 (57%) of the patients who underwent rectoscopy, the increase vvas more than 0.75 ng/mL. Free to total PSA ratio values decreased under the level of 20% in 30% of the patients. Conclusion: Short period after the procedures, colonoscopy and rectoscopy cause signifıcant increases in total and free PSA values and decreases in free/total PSA ratios without any correlation with age or procedure time. We believe that to avoid false interpretation, total and free PSA measurements should precede these procedures if they have to be obtained on the same day.
Özet
Kolonoskopi ve rektoskopinin serum total, serbest ve serbest/total prostat spesifik antijen (PSA) seviyeleri üzerine olan etkilerinin araştırıldığı prospektif bir çalışma yürütüldü. Kolonoskopi yapılan 28 hasta ve rektoskopi yapılan 19 hasta olmak üzere toplam 47 olgu çalışma kapsamına alındı. İşlem öncesi ve işlemden 2 saat sonra alman kan örneklerinde total ve serbest PSA değerlerine bakıldı, işlem öncesi ve sonrasında elde edilen bulgular arasında istatistiksel olarak anlamlı bir değişikliğin olup olmadığı ve yaş veya işlem süresinin bu değişikliklerle olan ilişkisi Paired t testi ile araştırıldı.Hem kolonoskopi hem de rektoskopi sonrasında istatistiksel olarak anlamlı şekilde total ve serbest PSA'da artış saptandı (p 0.05). Kolonoskopi sonrasında %89, rektoskopi sonrasında %94 hastada total PSA değerlerinde artış olmuştur. Bu artış 17 (%37) hastada 4 ng/mL'nin üzerindedir. PSA, kolonoskopi yapılan hastaların 14'ünde (%50) ve rektoskopi yapılan hastaların 11'inde (%57) yıllık artış hızı olan 0.75 ng/mL'nin üzerine çıkmıştır. Hastaların %30'unda serbest/total PSA oranı %20'nin altında saptanmıştır. Kolonoskopi ve rektoskopi erken dönemde yaş ve işlem süresinden bağımsız olarak total ve serbest PSA değerlerinde yükselmeye, serbest/total PSA oranında düşmeye neden olmaktadır.