在半身麻醉疝氣修補手術後中尿滯留對血清攝護腺抗原指數的影響

劉順琳¹, 蕭博任¹, 賴俊佑¹, 黃志平¹

中國醫藥大學附設醫院 泌尿部

The effect of urinary retention on serum prostate specific antigen after inguinal hernia repair under spinal anesthesia

Shun-Lin Liu¹, Po-Jen Hsiao¹, Chun-Yo Laih¹, Chi-Ping Huang¹

¹Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan

Purpose

To investigate the impact of urinary retention on serum prostate-specific antigen (PSA) concentration following inguinal hernia repair under spinal anesthesia.

Methods

Initially, we gathered 30 patients with BPH before performing inguinal hernia repair under spinal anesthesia. Following the operation, 3 patients with normal voiding function were excluded, resulting in a total of 27 patients being enrolled in the study. Serum PSA and free PSA concentrations were measured using radioimmunoassay. Subsequently, these patients experienced acute urinary retention post-surgery without catheterization. Bladder capacity was evaluated via sonogram, and serum PSA and free PSA levels were measured during the episode of acute urinary retention.

The present study received approval from the Research Ethics Committee of China Medical University Hospital, Taichung, Taiwan (IRB number: DNR-99-159). All procedures were conducted in accordance with the guidelines of the World Medical Association Declaration of Helsinki.

Results

The average age of the 27 patients was 62.27 years. They suffered from moderate to severe LUTS according to IPSS, with an average score of 11.19. The mean prostate volume before surgery was 35.26 ml. During urinary retention, the mean bladder distention volume was 505.11ml. The mean serum PSA levels of patients before and after urinary retention were 1.44 ng/mL and 1.32 ng/mL respectively. The mean serum free PSA levels of patients before and after urinary retention were 0.30ng/mL and 0.29 ng/mL respectively. The free to total PSA ratio before and after urinary retention were 25.38% and 27.09% respectively.

Conclusions

Urinary retention following spinal anesthesia did not lead to a significantly increase in serum PSA, free PSA, free to total PSA ratio among patients with BPH.