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Dr. Saha
Dr. Saha, Doctor (MD)
Category: Health
Satisfied Customers: 17824
Experience:  35 years of experience
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Urology question

Customer Question

urology question
Submitted: 10 months ago.
Category: Health
Expert:  Dr. Saha replied 10 months ago.

Thank you for your question.
I am Dr Saha, I shall try my best to help you.
Please write your question in detail.

Customer: replied 10 months ago.
I am 44 m-W, no family hx of Prostate CA. Had PSA test 09/15- 1.5 then 7/16- 1.1 then I just had one this thurs and it came in 10.9. My GP did DRE and told me everything felt normal. I am concerned about abnormal result. I don't have any significant urination or related symptoms.
Expert:  Dr. Saha replied 10 months ago.

Why did you have the tests?

What were your symptoms?

Did you have ultrasound?

Customer: replied 10 months ago.
I has some low T issues and was going to have a consult for starting some testosterone replacement. My testosterone was around 180 in July test. So I wanted to repeat the test and it was also 180 on this test. I just wanted to rule out any prostate issues prior to starting so it was more of a routine test. I did some TRT of about 6 month last year and felt good, but stopped because didn't want to be constantly on it. I did test for PSA a month after stoping and it was 1.2
Customer: replied 10 months ago.
I am just confused and concerned that PSA could jump over 10 points in less then 2 month.
Customer: replied 10 months ago.
I didn't have US, just DRE and DR said that he did not feel anything abnormal. He is internal medicine not urologist.
Expert:  Dr. Saha replied 10 months ago.

Thank you for all the information,
I feel you are concerned about cancer.

Though higher the level of PSA, the higher the risk but high PSA is not always diagnostic of cancer.

Inflammation & infection of prostate can also cause rise of PSA.

Recent sex, rectal examination & urine infection can also cause a rise.

As your doctor is not concerned, there is unlikely a serious issue.

However, an ultrasound can be taken if your doctor feels necessary.

You can discuss it with your doctor.
I hope this information helps.
If there’s anything else I can do, please let me know.
Please rate my answer excellent if you are satisfied with it.

Customer: replied 10 months ago.
You are correct that is my main concern. I would think Prostate tumor would cause a more gradual progressive rise in PSA. Could it be prostatitis with minimal symptoms. Would a course of antibiotics profolacticly be indicated and then a follow up PSA test after the course prior to going to US?
Expert:  Dr. Saha replied 10 months ago.

Yes, there can be prostatitis without much symptoms.

However, an urine test, swab test can be taken before deciding on antibiotics.

Customer: replied 10 months ago.
would urine test be positive for bacteria if it was prostatitis? He did take urine sample. He said it was negative on dipstick but he sent it to quest for further analysis. If urine is negative would antibiotics not be indicated?Also I did not use Quest for PSA but a mail away lab for cheaper costs. Is there possibility of lab making error on test or is uncommon?
Expert:  Dr. Saha replied 10 months ago.

Without definite evidence of infection, infection should not be prescribed.

Sometimes, it is possible to have erroneous result.

You can take a repeat test from another lab.

Customer: replied 10 months ago.
I am just concerned that the number was so high. So if urine culture is negative, probably just wait few weeks and repeat test with quest and if it stays elevated then request US or go to urologist for further evaluation or should I have more urgent appointment and follow up labs?
Expert:  Dr. Saha replied 10 months ago.

You are right.

If urine culture is negative you can wait sometime to have a repeat test.