Background: Following radical prostatectomy, urinary prostate-specific antigen (uPSA) may originate from periurethral glands or from recurrent carcinomatous prostatic cells. We evaluated massage of the urethro-vesical anastomosis as a uPSA-releasing method for the detection of local recurrence.
Methods: PSA was assessed (PSA IMx, Abbott Diagnostic, Rungis, France) in serum and in the first voided urine before and after massage in 59 patients: 7 after cystoprostatectomy for bladder cancer, 22 with prostate in situ, and 30 after radical prostatectomy for prostate cancer.
Results: No significant changes of uPSA were induced by the massage in cystoprostatectomy patients and in 4 radical prostatectomy patients with a negative biopsy of the anastomosis. In contrast, a significant increase of uPSA was observed after massage in the patients with prostate in situ and in 6 radical prostatectomy patients with biopsy-proven local relapse.
Conclusions: uPSA before and after massage of the prostatic fossa may constitute a new and efficient tool for the detection of local recurrence, if these preliminary results are confirmed on a larger scale.