Acute and chronic retention of urine: relevance of raised serum prostatic acid phosphatase levels. A prospective study.

A prospective study of serum prostatic acid phosphatase (PAP) levels in benign prostatic disease is reported. In 12 patients with acute retention the initial PAP level when compared with the level twenty-four hours after catheterization showed a significant fall (p less than 0.02). The initial PAP level was raised above the upper limit of normal in 7 patients (in 3 markedly so, of whom 2 had subsequent histologic evidence of prostatic infarction). In 10 patients with chronic retention there was a significant rise in the PAP level twenty-four hours after catheterization, but in only 1 case did this exceed the normal range. We discuss the significance of a raised PAP level in patients with acute retention and suggest that it may indicate a group of patients in whom the etiology of acute retention is spontaneous prostatic infarction and subsequently may require different management.