Introduction: The role of urinary proteomics in the diagnosis of prostate cancer (PCa) is undefined. Levels of urinary biomarkers such as prostate‑specific antigen (PSA) and microseminoprotein‑beta (MSMB) may differ between men with and without PCa. Objective: We tested this hypothesis using urine samples before and after digital rectal examination (DRE) in men with an indication for prostate biopsy. Materials and Methods: This prospective cohort study was done in Department of Urology, GRMC, Gwalior and approved by the institutional ethics committee and all individuals provided informed consent for inclusion. Men scheduled to undergo transrectal ultrasound (TRUS)‑guided biopsy of the prostate for suspicion of PCa due to either elevated PSA (>4 ng/mL) or a nodule on DRE were recruited. A sterile urine culture was confirmed before inclusion. Results: Seventy‑seven patients were recruited of whom 32 had PCa (Group A) and 45 had no cancer (Group B) on biopsy. The median (interquartile range) serum PSA was 49.6 (0.2–254) ng/ml. The median urine PSA (29.5 vs. 26.4 mg/dl) and MSMB (1.7 vs. 2.4 mg/dl) were similar in both groups at baseline. However, post‑DRE, both these metabolites rose in Group B but not in Group A, resulting in significantly higher post‑to‑pre values in Group B versus Group A. The post‑DRE urine PSA/MSMB ratio was also significantly different between the groups. Conclusions: Urinary PSA and MSMB rose significantly after DRE only in men without PCa. Post‑DRE urine PSA, MSMB, and PSA/MSMB ratio can differentiate PCa from benign pathology in men with an indication for prostate biopsy.

Introduction: The role of urinary proteomics in the diagnosis of prostate cancer (PCa) is undefined. Levels of urinary biomarkers such as prostate‑specific antigen (PSA) and microseminoprotein‑beta (MSMB) may differ between men with and without PCa. Objective: We tested this hypothesis using urine samples before and after digital rectal examination (DRE) in men with an indication for prostate biopsy. Materials and Methods: This prospective cohort study was done in Department of Urology, GRMC, Gwalior and approved by the institutional ethics committee and all individuals provided informed consent for inclusion. Men scheduled to undergo transrectal ultrasound (TRUS)‑guided biopsy of the prostate for suspicion of PCa due to either elevated PSA (>4 ng/mL) or a nodule on DRE were recruited. A sterile urine culture was confirmed before inclusion. Results: Seventy‑seven patients were recruited of whom 32 had PCa (Group A) and 45 had no cancer (Group B) on biopsy. The median (interquartile range) serum PSA was 49.6 (0.2–254) ng/ml. The median urine PSA (29.5 vs. 26.4 mg/dl) and MSMB (1.7 vs. 2.4 mg/dl) were similar in both groups at baseline. However, post‑DRE, both these metabolites rose in Group B but not in Group A, resulting in significantly higher post‑to‑pre values in Group B versus Group A. The post‑DRE urine PSA/MSMB ratio was also significantly different between the groups. Conclusions: Urinary PSA and MSMB rose significantly after DRE only in men without PCa. Post‑DRE urine PSA, MSMB, and PSA/MSMB ratio can differentiate PCa from benign pathology in men with an indication for prostate biopsy.