The Medical Journal of Basrah University

Abstract

ABSTRACT
Prostate specific antigen (PSA) has established itself as the most useful marker for adenocarcinoma of the prostate
(ADCA) adenocarcinoma of the prostate and in the recent years has almost replaced the total acid phosphatase and
prostatic acid phosphatase prostatic acid phosphatase (PAP) for screening, diagnosis and monitoring the prostate
carcinoma patients. The prostate specific antigen levels also rise in benign prostatic hypertrophy benign prostatic
hypertrophy but to a lesser extent and high values are usually diagnostic of malignant disease. A cross-sectional
comparative study was planned to see the effect of urinary retention and catheterization on plasma concentration of
adenocarcinoma of the prostate and prostatic acid phosphatase and the value of this effect in the diagnosis of patients
as having benign prostatic hypertrophy or adenocarcinoma of prostate. Sixty patients with prostatic disease were
included in the study. Adenocarcinoma of the prostate and prostatic acid phosphatase levels were assessed in all
patients. The patients were divided into two groups; group I are those presented with urinary retention and
catheterization and group II those presented without urinary retention (without catheter). Following histological
examination of prostatic tissues, the patients were diagnosed as cases of benign prostatic hyperplasia or
adenocarcinoma of prostate. The data were analyzed using t-test. Benign prostatic hypertrophy was detected in 48
patients whereas 12 patients were diagnosed with adenocarcinoma of the prostate. In the study, 66.2% of benign
prostatic hypertrophy and 50% of adenocarcinoma of the prostate patients presented with urinary retention and
catheterization. It was observed that prostate specific antigen levels were significantly raised in benign prostatic
patients with urinary retention and catheterization as compared to those with no retention. There was, however, no
significant rise in prostatic acid phosphatase levels in those patients. In conclusion, prostatic acid phosphatase is still
a very good tumor marker of prostatic disease in differentiating the malignant from the benign disease. It appears to
be particularly important in patients with benign prostatic hyperplasia and urinary retention as catheterization
appears to raise significantly the levels of prostate specific antigen but not those of prostatic acid phosphates. This
finding means that patients presenting with urinary retention and catheterization and high prostatic acid phosphates
levels are more likely having carcinoma of the prostate because retention and catheterization don’t significantly raise
the prostatic acid phosphates levels in benign prostatic hypertrophy as they raise prostate specific antigen levels in
such patients.