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The Effect of Digital Rectal Examination on the Serum Prostate Specific Antigen Concentration: Results of a Randomized Study

1992; Lippincott Williams & Wilkins; Volume: 148; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(17)36517-5

1527-3792

Frank M. Chybowski, Erik J. Bergstralh, Joseph E. Oesterling,

Urologic and reproductive health conditions

No AccessJournal of Urology1 Jul 1992The Effect of Digital Rectal Examination on the Serum Prostate Specific Antigen Concentration: Results of a Randomized Study Frank M. Chybowski, Erik J. Bergstralh, and Joseph E. Oesterling Frank M. ChybowskiFrank M. Chybowski , Erik J. BergstralhErik J. Bergstralh , and Joseph E. OesterlingJoseph E. Oesterling View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)36517-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail To determine the effect of digital rectal examination on the serum prostate specific antigen (PSA) concentration a prospective, randomized, controlled trial involving 143 patients was conducted. Of the patients 86 (60%) had benign prostatic hyperplasia (BPH), 47 (33%) had prostate cancer and 10 (7%) had chronic prostatitis. The study group consisted of 71 men, all of whom had a serum PSA determination followed by a digital rectal examination and then a second serum PSA determination. The control cohort consisted of 72 men, all of whom had 2 serum PSA determinations without an intervening digital rectal examination. The median change in the serum PSA level for the study group was 0.4ng./ml. compared to –0.1ng./ml. for the control cohort (p <0.0001). For 76% of the study patients the second serum PSA level was greater than the initial value; only 32% of the control patients exhibited a higher second serum PSA level than the initial level (p <0.0001). However, only 4 patients with an initial PSA value in the reference range (0.0 to 4.0ng./ml.) had a post-digital rectal examination value greater than 4.0ng./ml. and only 1 patient whose presenting serum value was less than 10.0ng./ml. had a serum PSA level greater than this cutoff point after digital rectal examination. This minimal change in serum PSA after digital rectal examination was independent of the diagnosis (BPH, cancer or chronic prostatitis), initial serum PSA concentration and examiner. Thus, although digital rectal examination had a statistically significant effect on the serum PSA concentration, the clinical significance of a 0.4ng./ml. median increase appears inconsequential. Based on these findings, physicians should be confident that the serum PSA concentration in the immediate post-digital rectal examination period is accurate and does not compromise clinical use of the tumor marker. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByPOLASCIK T, OESTERLING J and PARTIN A (2018) PROSTATE SPECIFIC ANTIGEN: A DECADE OF DISCOVERY-WHAT WE HAVE LEARNED AND WHERE WE ARE GOINGJournal of Urology, VOL. 162, NO. 2, (293-306), Online publication date: 1-Aug-1999.Cama C, Olsson C, Buttyan R, De Vries G, Wise G and Katz A (2018) Molecular Staging of Prostate Cancer. III. Effects of Cystoscopy and Needle Biopsy on the Enhanced Reverse Transcriptase Polymerase Chain Reaction AssayJournal of Urology, VOL. 157, NO. 5, (1748-1751), Online publication date: 1-May-1997.Colombo T, Zigeuner R, Altziebler S, Pummer K, Stettner H and Hubmer G (2018) Effect of Extracorporeal Shock Wave Lithotripsy on Prostate Specific AntigenJournal of Urology, VOL. 156, NO. 5, (1682-1684), Online publication date: 1-Nov-1996.Plawker M, Fleisher J, Nitti V and Macchia R (2018) Primary Care Practitioners: An Analysis of their Perceptions of Voiding Dysfunction and Prostate CancerJournal of Urology, VOL. 155, NO. 2, (601-604), Online publication date: 1-Feb-1996.Partin A and Oesterling J (2018) The Clinical Usefulness of Prostate Specific Antigen: Update 1994Journal of Urology, VOL. 152, NO. 5 Part 1, (1358-1368), Online publication date: 1-Nov-1994.Rana A and Chisholm G (2018) He Sold His Bike for a Low Prostate Specific AntigenJournal of Urology, VOL. 151, NO. 3, (700-700), Online publication date: 1-Mar-1994. Volume 148Issue 1July 1992Page: 83-86 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmscarcinomaantigens, neoplasmMetricsAuthor Information Frank M. Chybowski More articles by this author Erik J. Bergstralh More articles by this author Joseph E. Oesterling More articles by this author Expand All Advertisement PDF DownloadLoading ...