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Having pain in prostrate area. Test showed PSA 2.9. Urine test normal. Noticed inflammation. Suggestions?

Jul 2016
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I have recently been screened in the prostate area, as I have felt some pain in what I believed was the prostate region.
Tests conducted were PSA, which read as 2.9, which is slightly high.
The ultrasound covered the kidneys and gland from the front of the abdomen (there was no transrectal ultrasound done).
Also, I did a urine flow rate test, which was normal.
A digital rectal exam was done and some discomfort was experienced in some positions.
I have also been prescribed an MRI of the pelvis and prostate, will the MRI further help to diagnose the problem, if any? There is no enlargement of the prostate based on the ultrasound but it seems inflammation is still a possibility.
The urologist mentioned that a low-grade growth is a possibility and I am wondering how sensitive the MRI would be to picking up such an issue?

Posted Thu, 3 Oct 2013 in Men's Health
Answered by Dr. P. T. Patil 1 hour later
Brief Answer:
It could be a prostatitis.

Detailed Answer:
Thanks for your query.Based on the facts that you have posted it appears that you have been screened for prostate problem.
You have undergone following test
1) Serum PSA. -Your Serum PSA is 2.9 which is normal.
Serum PSA above 4 is suspicious of cancer of the prostate.
2) Ultrasound scanning revealed that prostate is not enlarged
3) Uroflometry study revealed normal urine flow which rules our outflow obstruction due to enlarged prostate.

Looking at the results of these tests you do not have either enlarged prostate or Cancer of the prostate.
Pain in rectal area could be due to acute prostatitis confirmed on digital rectal examination.

Your Urologist has advised MRI which is highly specific test and can detect even any minor pathology in pelvis.Please go ahead and get it done to confirm the diagnosis.

Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you

Above answer was peer-reviewed by
Follow-up: Having pain in prostrate area. Test showed PSA 2.9. Urine test normal. Noticed inflammation. Suggestions? 50 minutes later
Thanks Dr. XXXXXXX

However, I am concerned that the MRI is not specific enough to diagnose growths in the prostate or to pick up on them in that area. The only way to do so in my understanding is currently through the use of the prostate biopsy gun to take samples are various points in the prostate for further pathological examination.

Do you have any statistics on the sensitivity of the MRI for detecting prostate growths compared to the ultrasound?

Answered by Dr. P. T. Patil 30 minutes later
Brief Answer:
Prostate Bopsy is the definative diagnostic tool.

Detailed Answer:
Thanks for follow up.
Since the preliminary tests like PSA, Digital Rectal examination and ultrasound scanning are not positive to suspect growth in the prostate your Urologist has asked for MRI. It is likely that he may be suspecting something else in the pelvic region as cause of pain in rectal area.

As regards my comments on sensitivity of MRI I have made the comments in general and not for growth in the prostate.

Though multi core prostate biopsy is the definitive investigation to confirm the cancer of the prostate we in India do not go for it unless there is positive suspicious finding as raised PSA or palpable hard nodule on digital rectal examination.
Thanks and Regards.
Above answer was peer-reviewed by
Follow-up: Having pain in prostrate area. Test showed PSA 2.9. Urine test normal. Noticed inflammation. Suggestions? 1 hour later
Thanks Dr. XXXXXXX

I am aware of the diagnostic options and their uses now.

However, I forgot to mention that my PSA when checked three years ago was 2.7, then 2.8 a year ago and now 2.95. So, I am wondering why it is slowly increasing and whether that is significant?

Answered by Dr. P. T. Patil 8 minutes later
Brief Answer:
Rise of 0.1 every year is not significant at all.

Detailed Answer:
Thanks for follow up.
Rise of 0.1 in two years is not significant at all.

Thanks and Regards,
Above answer was peer-reviewed by
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