Comparison in the follow-up of two patients with persistent elevated PSA and negative prostate biopsy. Issue 24 (July 2014)

• Record Type: Journal Article
• Authors: Sciarra, Alessandro; Panebianco, Valeria
• Is Part Of: Urologia journal. Volume 81:Issue 24(2014)Supplement
• Page Start: 21
• Page End: 24
• Publication Date: 2014-07
• Subjects: Prostate neoplasm -- Magnetic resonance -- Dutasteride -- Prostate biopsy -- Neoplasia prostatica -- Risonanza magnetica -- dutasteride -- Biopsia prostatica; Urology -- Periodicals; 616.6005
• DOI: 10.5301/urologia.500055
• Languages: English
• ISSNs: 0391-5603

Abstract

Purpose: To compare two clinical cases on the follow-up of patients with benign prostatic hyperplasia at risck of progression, negative prostate biopsy and persistent elevated PSA levels. Materials: After a first negative prostate biopsy for elevated PSA levels, Case A received dutasteride therapy for benign prostatic hyperplasia, whereas Case B continued his therapy without dutasteride. In both cases, other diagnostic procedures or other biopsies were decided on the basis of PSA level modifications. Results: Case A showed a stabilization of PSA levels with a new nadir; the patient did not undergo new biopsies or other diagnostic procedures till the presence (24 months of follow-up) of a PSA elevation despite dutasteride therapy. A new biopsy, then, showed a prostate adenocarcinoma. Case B showed persistent and progressive PSA elevation; the patient underwent other diagnostic procedures and 2 new negative biopsies. Only after 26 months of follow-up a further biopsy showed a prostate adenocarcinoma. Conclusions: 5-alpha-reductase inhibitors can reduce the number of unnecessary prostate biopsies.