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Benign prostratic hyperplasia problem - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Men's Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   MY PSA levels since 2004 have gone from 2.3, 2.5 2.7 3.2 3.8 to 4.8 now. My score this year could be elevated due sex 6hrs before and doctor doing DRE 20 minutes before exam. I am 62 with an enlarged prostate. Your thoughts
Doctor :   Hi
Doctor :   do you have any symptoms ?
User :   No I do not
Doctor :   can you tell me what exactly do you mean that your PSA level will increase because of intercourse during that time period ?
Doctor :   intercourse has no relation to the increase or decrease of PSA levels
Doctor :   nor a rectal exam will cause any fluctuations
Doctor :   your PSA level are in the higher levels and you need further evaluation
User :   That being the case wht do you think my course of action should be
Doctor :   elevations in the PSA can also be caused by conditions other than prostate cancer. For example, benign prostatic hyperplasia (BPH) and infection or inflammation of the prostate (prostatitis) from whatever cause can elevate the PSA.
Doctor :   first of all these conditions should be ruled out
Doctor :   a simple urine test will rule out the prostatitis
Doctor :   next you should go for a biopsy of the prostate gland
Doctor :   that will help us to pinpoint the exact cause
Doctor :   The biopsy is done from the rectum (trans-rectally) and is guided by ultrasound images of the area. A small piece of prostate tissue is withdrawn through a cutting needle.
Doctor :   that is your next step in finding the exact cause of the increase
Doctor :   we cannot make a diagnose of any cancer UNLESS the biopsy is done and like i said that there are other conditions too that can cause the increase in PSA , so we have to be sure
User :   I believe this is what I will ask for from the doctor tomorrow. What are the odds that mine will come positive. Most online reports show that Psa levels of >4.0 and less than 10 will have 70% of coming back negative
Doctor :   yes thats correct
Doctor :   but we should not take any chances
Doctor :   thats why we follow a protocol to make sure the exact cause is found
Doctor :   and you can be treated accordingly
User :   How long does it take to receive results after test
Doctor :   its usually done in a single day
Doctor :   by taking the blood sample
Doctor :   depending in the hospital the report can take time
Doctor :   but the DRE should not be done before
Doctor :   it does cause a minor increase but in your case since the level was above 4 , thats why we want further testing
User :   I thought a biopsy consisted of tissue samples and not blood
Doctor :   i thought you wanted to know about the PSA testing, sorry i apologize
Doctor :   in the biopsy procedure
Doctor :   A small piece of prostate tissue is withdrawn through a cutting needle. The TRUS-guided Tru-Cut biopsy is currently the standard method to diagnose prostate cance
Doctor :   after which A pathologist, a specialist physician who analyzes tissue samples under a microscope, then examines the pieces under the microscope to assess the type of cancer present in the prostate and the extent of involvement of the prostate with the tumor. One also can get an idea about the areas of the prostate that are involved by the tumor by assessing which of the pieces contain the cancer and which of them do not.
Doctor :   The biopsy is done from the rectum and is guided by ultrasound images of the area
Doctor :   If a prostate biopsy is done under local anesthesia through the area between the anus and scrotum (perineum), no other special preparation is needed.
If the biopsy is done through the rectum, you may need to have an enema before the biopsy.
Doctor :   If the biopsy is done under general anesthesia, your doctor will tell you how soon before surgery to stop eating and drinking. In most cases, you will need to stop eating at least 6 hours before your surgery. You may be able to drink clear liquids, such as water, coffee, or tea, up to 2 hours before surgery. But be sure to follow the exact instructions your doctor gives you.
Doctor :   what procedure will be followed for you will be discussed by your physician
Doctor :   dont worry the level in your case is borderline high and hopefully you will be treated completely
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