[Does antibiotherapy prevent unnecessary prostate biopsies in patients with high PSA values?].

INTRODUCTION We investigated if antibiotherapy has any role on total PSA (tPSA), free PSA (fPSA) and fPSA/tPSA ratio in patients with tPSA higher than 2.5ng/ml. We also analyzed if it has any relation with prostate cancer diagnosis rate. MATERIAL AND METHODS A total 108 patients older than 50 years of age with lower urinary system sypmtoms and tPSA >2.5ng/ml were included in this study. Antibiotherapy was given to all the cases for three weeks. After that, transrectal ultrasound-guided prostate biopsies were taken from all the patients. Before and after antibiotherapy, "The International Prostate Symptom Score" (IPSS) and "National Institutes of Health Chronic Prostatitis Symptom Index" (NIH-CPSI) questinories are performed and serum tPSA, fPSA and fPSA/tPSA values were obtained. RESULTS TPSA, fPSA and fPSA/tPSA ratio alterations prior to and after antibiotherapy did not show any statistically significant difference (p>0.05). When prostate adenocarcinoma was excluded, an statistically significant decrease was found in IPSS and NIH-CPSI scores for all cases. CONCLUSIONS Antibiotherapy given to patients with PSA levels higher than threshold value has not led to significant change in prostate needle biopsy decision. Prostate biopsy should be considered without trying antibiotherapy in patients with high PSA values if a suspicion of prostatitis does not exist.