Ruolo della terapia antibiotica in pazienti candidati alla biopsia prostatica per sospetto carcinoma prostatico T1c

The correlation between chronic prostatitis and increase in the PSA is still controversial. Presuming that clinically silent foci of chronic prostatitis could have caused an increase in the PSA, we administered Ciprofloxacin for 21 days to 40 patients with PSA between 4 and 10, negative DRE and absence of clinical signs of prostatitis. After therapy the PSA delta (repeated - initial) was calculated and all the patients were subjected to a biopsy. There were variations in the PSA in 52% of the patients, suggesting, independently of the histological examination, the probable presence of prostatic inflammatory foci. All the patients with histological exam showing inflammation associated or not with prostatic hyperplasia had a decreased or unvaried PSA. Similar variations in the PSA, however, were noted in all the histological types, including adenocarcinoma of the prostate. Determination of the PSA delta after antibiotic therapy is not a useful parameter in discriminating prostate cancer in patients with PSA between 4 and 10 and negative DRE.