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Prostate aggravated by hernia. Would a hernia or changed blood thinners have any effect on PSA levels?

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Practicing since : 1995
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Would a hernia have any effect on PSA levels? My husband has a huge untreated hernia and just recently got terrible PSA readings. Eighteen months ago his PSA was fine, 3 weeks ago is was 42, last week a follow up confirmatory test was a 61. Of course I'm worried. And just hit on this wish that maybe it's because his prostate has in some way been aggravated by the hernia (I've heard the rectal exam itself can raise PSA, so I thought maybe...)
he also changed blood thinners recently -- could that affect PSA?
Posted Mon, 21 May 2012 in Men's Health
Answered by Dr. V. Sasanka 9 hours later
It is very unlikely that hernia affects PSA levels in the serum. If it is indeed going up as you said, I suggest you get an ultrasound examination of bladder and prostate and a rectal examination for the prostate, and a trans-rectal ultrasound guided biopsy if there is no clinical evidence of infection.
Rectal examination never raises PSA to these kind of levels.
Similarly, blood thinners also do not alter Serum PSA values.
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Follow-up: Prostate aggravated by hernia. Would a hernia or changed blood thinners have any effect on PSA levels? 13 hours later
Thank you.

By clinical evidence of infection -- do you mean the ultrasound and rectal exam can reveal evidence of infection, or is response to antibiotics the only way we'd know it was infection?

Would cancer or an infection be equally likely to cause an increase that rapid? I am hoping of course you say cancer does not advance that rapidly, it's more likely to be infection.
Answered by Dr. V. Sasanka 55 minutes later
1) Yes - To a reasonably good extent, a rectal examination and ultrasound can suggest infection. On Rectal examination, acutely infected prostates are tender, and boggy to touch, though not always. Similarly, in prostate infections ultrasound picture would be of what we call heterogenous echotexture of prostate in contrast to a 'homogenous' smoother echoes in normal prostate, and hypoechoic nodules in cases of malignancies of prostate(again, not always). Aside from these two, a complete blood picture for any elevated WBC count, a urine analysis for pus cells with culture and sensitivity examination are required before any decision can be made regarding doing prostate biopsy for a patient with elevated PSA. This is because doing a biopsy in acutely inflamed prostates can make the sepsis worse.
2) Without a clinical examination, it would be difficult to comment regarding a raise in PSA but as you seem to have realized, a sudden sharp spurt in PSA is more suggestive of infection, especially if the assay of PSA was done in the same lab on both the occasions. So an empiric course of antibiotics followed by a repeat PSA after 3-4 weeks might give a better pcture. Prostate infections are notoriously hard to eradicate, and thus may needs weeks of antibiotics before PSA comes down.
Above answer was peer-reviewed by
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