Relationship of prostate volume and prostate-specific antigen levels in Sri Lankan men with Benign Prostatic Hyperplasia

Purpose: Benign Prostatic Hyperplasia (BPH) is an important cause of morbidity for ageing men worldwide. However, the available study is limited on the natural history of BPH and dynamics of Prostate-Specific Antigen (PSA) in Sri Lankan population. This study aimed to assess the relationship between serums Prostate Specific Antigen (PSA), prostate volume (PV), and PSA density (PSAD) and to evaluate variations of above parameters with aging and to assess the mean prostate volume of Sri Lankan men with Benign Prostatic Hyperplasia (BPH).

Material and methods: This was a retrospective study, men diagnosed with Benign Prostatic Hyperplasia from January 2009 was evaluated. This study was approved by the Ethics Review Committee of Colombo South Teaching Hospital and the patient informed written consent was received. Those with UTI, PSA >10ng/dl and suspicious prostate in digital rectal examination (DRE) were excluded from the study. Data were statistically analyzed to determine the relationship of PSA, PV, PSAD and variations with age groups.

Results: This study recruited a total number of 562 men, clustered into 5 age groups and their mean Prostate Volume (PV) was 42.9 (12.56SD). The median PSA was 2.5ng/dl with an inter quartile range of 0.37. The mean PSA density (PSA/PV) was 0.11 (0.023SD). The tendency towards increase in PSA and prostate volume with increasing age showed statistical significance (P<0.05). PSA density was not changed much between different age group except 51-60 age group. It is noted PSAD was fluctuating around mean PSAD of 0.11 in majority of the age groups.

Conclusion: PV and PSA increase with age. Mean PV is relatively small compare to blacks and Caucasians. .PSA density in Sri Lankan men is comparable to published data in other countries and could be used as a surrogate marker to evaluate the prostate and for therapeutic decision making.