PSA value of 11, but I have a UTI.

[simon43]

I did a blood/urine test today.  The results indicated that I currently have bacteria and white cells in my urine (presumably caused by a UTI).  My PSA result was 11.  My last PSA test a few years ago (and previous to that) had a stable PSA value of about 6, slightly raised due to BPH.  In the past couple of years, my BPH symptoms have increased, so I now take a daily tablet to enable me to pee.

 

Should I be worried by the PSA of 11?  Dr Google tells me that BPH will increase my PSA and a UTI will also increase it.  How long should I wait before repeating the PSA test?  I hadn't noticed any UTI symptoms - should I take some medication to sort that out?  Thanks.

[BritManToo]

18 minutes ago, simon43 said:

Should I be worried by the PSA of 11?  Dr Google tells me that BPH will increase my PSA and a UTI will also increase it.  How long should I wait before repeating the PSA test?  I hadn't noticed any UTI symptoms - should I take some medication to sort that out?  Thanks.

UTI is a pain, I usually take a 1/2 dose of Cipro or NorfloxStar for 5 days. (1/2 tablet 2x a day)

Blood in urine after exercise is my symptom, recurs every 2 months or so.

 

 

No PSA test problems though.

But nearly all my BPH symptoms have gone after taking the antibiotics a few times. I no longer need to take tablets to wee.

[BostonJoe]

At 11 I would certainly  go see the Doctor  

[simon43]

25 minutes ago, BritManToo said:

UTI is a pain, I usually take a 1/2 dose of Cipro or NorfloxStar for 5 days. (1/2 tablet 2x a day)

Blood in urine after exercise is my symptom, recurs every 2 months or so.

 

 

No PSA test problems though.

But nearly all my BPH symptoms have gone after taking the antibiotics a few times. I no longer need to take tablets to wee.

To be honest, I haven't tried not taking the BPH medication.  I guess I should give that a go ????

 

Dr Google tells me that a UTI will definitely raise my PSA value.  He also says that I need to wait about 1 month before repeating the PSA test after clearing the UTI.  But in any case, I will go and chat with the doctor in the meantime.

[JimmyJ]

13 hours ago, BritManToo said:

 

No PSA test problems though.

 

Based on posts of yours including one very recently, I'm curious why you get PSA tested.

 

If you ever had a high PSA  reading and ultimately a biopsy and cancer cells were found, are there any treatments you would accept?

[Sheryl]

See a urologist. You may have prostatitis.

 

And - very important: get a urine culture before starting antibiotics.

 

Even PSA of 6 would have warranted a work up (DRE and ultrasound)

[JimmyJ]

simon43 - Did you do the Urine Test midstream?

[simon43]

2 hours ago, JimmyJ said:

simon43 - Did you do the Urine Test midstream?

Ah no..... that could also be an issue.

 

Sheryl, My PSA test 8 years ago gave a result of 7.5, and 5 years ago it was 5. I did have a DRE 8 years ago, and only an enlarged prostate was found, nothing suspicious. Anyway, I'll go and see Dr Oliver in Pattaya on Monday and consult his wisdom on this matter. 

[xylophone]

36 minutes ago, simon43 said:

Ah no..... that could also be an issue.

 

Sheryl, My PSA test 8 years ago gave a result of 7.5, and 5 years ago it was 5. I did have a DRE 8 years ago, and only an enlarged prostate was found, nothing suspicious. Anyway, I'll go and see Dr Oliver in Pattaya on Monday and consult his wisdom on this matter. 

Good luck Simon and please post the outcome!

[IvorBiggun2]

I told a doctor tuther week that I was going to have a PSA test done. He told me that unless i was showing symptoms of prostate problems not to bother. So I did a bit of Google-ing and took the doctors advice.

 

Quote

The test doesn't always provide an accurate result. An elevated PSA level doesn't necessarily mean you have cancer. And it's possible to have prostate cancer and also have a normal PSA level.

https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731#:~:text=The test doesn't always,have a normal PSA level.

[Lacessit]

I have significant BPH, my last PSA was 0.7 ng/mL. Admittedly the finasteride I am taking tends to lower PSA readings. My highest reading prior to finasteride was 1.7 ng/mL

According to the pathology report, normal range is 0-4 ng/mL. A reading of 11 IMO is suspicious with or without a UTI, as the OP said his previous level was 6.

[Lacessit]

4 minutes ago, IvorBiggun2 said:

I told a doctor tuther week that I was going to have a PSA test done. He told me that unless i was showing symptoms of prostate problems not to bother. So I did a bit of Google-ing and took the doctors advice.

 

https://www.mayoclinic.org/tests-procedures/psa-test/about/pac-20384731#:~:text=The test doesn't always,have a normal PSA level.

Er - your avatar says "Gender-not telling" and you were thinking of a PSA test? Thanks for the chuckle.

[Rimmer]

An unattributed post and reply have been removed

[lopburi3]

On 10/7/2022 at 5:22 PM, BritManToo said:

Blood in urine after exercise is my symptom, recurs every 2 months or so.

Be pro active with that as could be serious (was for me) - perhaps ultrasound to examine bladder.  Mine was also after exercise but caused by cancer in bladder (which with earlier detection might have saved me the bladder etc).  

[BritManToo]

On 10/8/2022 at 7:02 AM, JimmyJ said:

Based on posts of yours including one very recently, I'm curious why you get PSA tested.

 

If you ever had a high PSA  reading and ultimately a biopsy and cancer cells were found, are there any treatments you would accept?

It was part of my BPH treatment at government hospital.

I've stopped having it now.

[moogradod]

On 10/7/2022 at 5:08 PM, simon43 said:

Should I be worried by the PSA of 11?  Dr Google tells me that BPH will increase my PSA and a UTI will also increase it

Dr. Google is not qualified for such a controversial issue and a PSA of 6, let alone 11 would concern me. Apart from the value the change rate is important. Go see an urologist immediately and he would know what to do in your specific case. But dont wait. No self medication as well. Never ever do downplay this issue.

 

Advice from a cancer patient with highly agressive cancer (Gleason Score 8). The score may only be obtained after a puncture. You would rather go for that than having cancer in all its aspects, and there are many. Promise.

[simple1]

15 hours ago, moogradod said:

Dr. Google is not qualified for such a controversial issue and a PSA of 6, let alone 11 would concern me. Apart from the value the change rate is important. Go see an urologist immediately and he would know what to do in your specific case. But dont wait. No self medication as well. Never ever do downplay this issue.

 

Advice from a cancer patient with highly agressive cancer (Gleason Score 8). The score may only be obtained after a puncture. You would rather go for that than having cancer in all its aspects, and there are many. Promise.

I concur with above. I had no symtoms whatsoever, but had a PSA test as was over 60. Came back with a PSA score of nine. According had the prostate cancer check which diagnosed as advanced / aggressive. Had the operation, but too late as had spread outside of the prostate requiring ongoing esculating treatment; thankfully to date pain management not needed. Strongly recommend you undertake prostate cancer investigation.

[simon43]

1 hour ago, simple1 said:

I concur with above. I had no symtoms whatsoever, but had a PSA test as was over 60. Came back with a PSA score of nine. According had the prostate cancer check which diagnosed as advanced / aggressive. Had the operation, but too late as had spread outside of the prostate requiring ongoing esculating treatment; thankfully to date pain management not needed. Strongly recommend you undertake prostate cancer investigation.

Yes, I have an appointment this morning with a recommended urology specialist at Bangkok Hospital, Pattaya.  Best to expect the worst and hope for the best ????

[simon43]

Update:  I visited the urology specialist today at Bangkok Hospital, Pattaya. Tests indicated that I still had bacteria in my pee, (possibly from the bacterial bronchitus that I had a few weeks ago or from a UTI or prostitis, even though I have no symptoms of prostatis, other than my usual BPH symptoms). 

 

Anyway, that bacteria will definitely cause an increase in PSA.  So I've been prescribed antibiotics to sort out the bacteria infection, and then another PSA test will be performed.

 

Additionally, the DRE test that the doctor performed was encouraging.  An enlarged prostate for sure, but a rubbery texture and no hardness.  But even if/when the new PSA is lower (my typical PSA value for the past 8 years has been around 6, with no change), I think it would be prudent to have a biopsy or MRI etc to check that nothing is amiss.  My medical insurance will cover any necessary outpatient and inpatient tests and treatment for prostate cancer (I checked the policy!).

 

 

[LosLobo]

6 hours ago, simon43 said:

Update:  I visited the urology specialist today at Bangkok Hospital, Pattaya. Tests indicated that I still had bacteria in my pee, (possibly from the bacterial bronchitus that I had a few weeks ago or from a UTI or prostitis, even though I have no symptoms of prostatis, other than my usual BPH symptoms). 

 

Anyway, that bacteria will definitely cause an increase in PSA.  So I've been prescribed antibiotics to sort out the bacteria infection, and then another PSA test will be performed.

 

Additionally, the DRE test that the doctor performed was encouraging.  An enlarged prostate for sure, but a rubbery texture and no hardness.  But even if/when the new PSA is lower (my typical PSA value for the past 8 years has been around 6, with no change), I think it would be prudent to have a biopsy or MRI etc to check that nothing is amiss.  My medical insurance will cover any necessary outpatient and inpatient tests and treatment for prostate cancer (I checked the policy!).

 

 

I would suggest that is no advantage of having a biopsy without an MRI first.

It is only necessary to have a biopsy for prostate cancer if your MRI shows a positive or a suspicious result first.

 

Why have a very invasive procedure and risk infection especially with a trans-rectal biopsy when a biopsy may not be required.

 

I don't think trans-perineal biopsies are the norm in Thailand yet. though it's rate of sepsis post biopsy is nearly 0%, which is 40 to 70 times less than that of trans-rectal.

 

"In a trial of population-based screening by invitation, our results showed that among men with elevated PSA levels, combined biopsy performed only in men who had positive results on MRI was noninferior to standard biopsy for detecting clinically significant prostate cancer."

 

MRI-Targeted or Standard Biopsy in Prostate Cancer Screening | NEJM

[simon43]

32 minutes ago, LosLobo said:

I would suggest that is no advantage of having a biopsy without an MRI first.
...

I agree with you.  I was consulting ancient Dr Google pages which didn't mention MRI scans! My doctor said that we need to clear the bacterial infection first, then check the PSA again, then decide what to do next if the PSA value is high or normal (for me).  My PSA value has been about 5 for the past 8 years, which is about normal for a man in his 60's with BPH.  If my PSA comes back as 7 or higher for example, then we need to investigate more.  But so far, I'm encouraged by the results of the DRE today.

[LosLobo]

12 minutes ago, simon43 said:

I agree with you.  I was consulting ancient Dr Google pages which didn't mention MRI scans! My doctor said that we need to clear the bacterial infection first, then check the PSA again, then decide what to do next if the PSA value is high or normal (for me).  My PSA value has been about 5 for the past 8 years, which is about normal for a man in his 60's with BPH.  If my PSA comes back as 7 or higher for example, then we need to investigate more.  But so far, I'm encouraged by the results of the DRE today.

I think if you are compliant with BPH medication like Duodart etc, they will drop your PSA by half the component the BPH is causing, urologists seem to be able to calculate from this any untoward component of your PSA reading.

 

Wish you luck with the antibiotics dropping the PSA.

 

I think in the West, consecutive PSA's of over 5.5 and/or a high risk from family relationships indicate a MRI screening.

[Sheryl]

Ultrasound would usually be first step

 

Then possibly MRI

 

As other poster said biopsy is indicated only if there are suspicious findings. 

[simon43]

Update:

 

After my PSA value of about 11.2 some weeks ago, a UTI was found. The DRE was normal, inasmuch as can be felt with a finger. My doctor therefore prescribed antibiotics to sort out the UTI.  This has now all cleared up and so I had another PSA test a few days ago which indicated a value of 14.6.  This is not good news....  I am currently on Koh Phangan, but have booked to see the urology specialist at Bangkok Samui hospital this Saturday.

[xylophone]

1 hour ago, simon43 said:

Update:

 

After my PSA value of about 11.2 some weeks ago, a UTI was found. The DRE was normal, inasmuch as can be felt with a finger. My doctor therefore prescribed antibiotics to sort out the UTI.  This has now all cleared up and so I had another PSA test a few days ago which indicated a value of 14.6.  This is not good news....  I am currently on Koh Phangan, but have booked to see the urology specialist at Bangkok Samui hospital this Saturday.

Good luck Simon.

[Sheryl]

I would really urge that you come to Bangkok gor this.

[simon43]

1 hour ago, Sheryl said:

I would really urge that you come to Bangkok gor this.

Sheryl, I plan to have the initial investigation work (scan etc) in Samui.  If treatment is required, which sounds likely, then I will come and stay in Bangkok.  April Insurance has already confirmed that all investigation/treatment costs are covered and will be paid directly by them etc.

 

Out of interest, why do you urge me to come to Bangkok?

[Sheryl]

1 hour ago, simon43 said:

Sheryl, I plan to have the initial investigation work (scan etc) in Samui.  If treatment is required, which sounds likely, then I will come and stay in Bangkok.  April Insurance has already confirmed that all investigation/treatment costs are covered and will be paid directly by them etc.

 

Out of interest, why do you urge me to come to Bangkok?

Quality of the specialusts and availability of specialized scans.

 

With this problem diagnosis is complex and tricky.

[Sheryl]

By the way, Bangkok Samui is a tiny hospital, only 50 beds. Does not normally have much in the way of specialists present.

[Boyn]

Simon43 the faster you move on this the better for you, my PSA was 5.8 my doctor was not too concerned, turned out i had advanced prostate cancer, im still alive 6 years down the road although some harsh treatment. Dont want to scare you but get moving.