PSA velocity in conservatively managed BPH: Can it predict the need for BPH-related invasive therapy?

OBJECTIVE. To study the value of PSA velocity (PSAV) to predict benign prostatic hyperplasia (BPH) progression in patients managed with alpha(1)-blockers or watchful waiting (WW). METHODS. Nine hundred and forty two BPH patients treated with alpha(1)-blocker or WW were reviewed. PSAV was defined as: (PSA(t)-PSA(b))/(t/12); where PSA(t) = PSA at time of follow-up (t, in months), PSA(b) = PSA at baseline. PSAt was taken from the I year follow-up visit or, if not present, from the next available visit with a maximum of 24 months. RESULTS. Five hundred and ninety five patients (234 alpha 1-blocker, 361 WW) were included in the analyses. PSAV range was -5.24 to 43.06 ng/ml/year in alpha(1)-blocker patients and -6.11 to 19.55 ng/ml/year in WW patients (median: 0.01 ng/ml/year). PSAV was stratified into tertiles (Stable/ Decrease/ Increase). There were no significant differences in retreatment-free survival and the risk of BPH-related invasive therapy between the tertiles in both treatment groups. CONCLUSIONS. PSAV did not predict BPH progression in either a,-blocker treated patients or WW group.