is the serum prostate-specific antigen level affected by urethral catheterization in patients with acute urinary retention?

Background: the reason for elevated serum prostate-specific antigen (psa) levels in patients undergoing urethral catheterization due to acute urinary retention (aur) remains a significant and controversial issue. objectives: to assess the serum psa level in men with aur and its changes after catheterization. methods: this prospective quasi-experimental study was conducted on 43 patients who underwent transurethral catheterization following aur caused by benign prostatic hyperplasia (bph). total psa levels and free/total psa ratios were measured before catheterization and one and three days after catheter insertion. additionally, prostate volume and urine output after catheterization (uoac) were recorded. results: the mean age, prostate volume, and uoac of the patients were 69.05 ± 9.45 years, 60.51 ± 26.35 g, and 844.04 ± 341.66 ml, respectively. the mean and median baseline total psa levels were 12.59 ± 17.71 ng/ml and 6.30 ng/ml, respectively. these values changed to 13.73 ± 19.83 ng/ml (median = 4.80 ng/ml) and 11.57 ± 17.70 ng/ml (median = 4.40 ng/ml) after 1 and 3 days of catheterization, respectively. the changes in total psa and free/total psa levels during the study period were not statistically significant (p > 0.05).moreover, the psa levels showed no statistically significant difference before, 1 day, and 3 days after catheterization in groups with total psa ≤ 4 and total psa > 4 (p = 0.37; 0.22, respectively). conclusions: our results suggest an initial elevation in psa levels in patients with aur before urethral catheterization. both psa and free/total psa ratios showed no statistically significant differences before and after urethral catheter insertion, and initial psa did not affect its changes after catheterization.