The Effect of Surgical Stress on Serum Prostate Specific Antigen Level

Objective: Invasive surgical interventions creating acute stress may give rise to immunological and hormonal disturbances in patients undergoing surgery. Previous studies reported elevations in serum prostate-specific antigen (PSA) level following coronary bypass and myocardial infarction. The current study aims to investigate the effect of surgical stress on serum PSA level. Methods: Thirty-three patients who underwent open renal stone surgery, without any known infectious prostatic disorder or prostate cancer that may elevate serum PSA level, were included in the study. In all patients, serum levels of total and free PSA (tPSA and fPSA), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total and free testosterone, C-reactive protein (CRP), fibrinogen, albumin, and ferritin and erythrocyte sedimentation rate (ESR) were measured both at baseline and post-operative day 3. Wilcoxon signed-rank test was used for the statistical analysis. Results: The mean age of patients was 53.9 +/- 8 (40-66). The mean baseline and post-operative levels of the measured serum parameters are given in Table 1. All of them differed significantly between baseline and post-operative day 3, except for LH, tPSA, and fPSA. CRP, fibrinogen, ferritin, and ESR are known as acute phase reactants of the post-operative endocrine response. However, serum total and free testosterone levels, albumin, and FSH decreased on the contrary acute phase reactants in the present study. Conclusion: According to our results, serum PSA level was not affected by acute surgical stress.