OVERVIEW
Prostate specific antigen, also known as PSA, is made in the prostate and circulates in the bloodstream. It is a non-specific test that can indicate an enlarged prostate (BPH), urinating issues, infection of the bladder or prostate or potentially prostate cancer.
Symptoms
Oftentimes there are no symptoms associated with an elevated PSA; however, symptoms can include:
- Sudden change in urinary symptoms
- Urinary tract infection symptoms (i.e. burning with urination, urinary frequency or urgency, lower abdominal discomfort or pelvic pain)
Causes
While there are many different causes for an elevated PSA, it is most commonly due to one of the following: enlarged prostate (BPH), prostate cancer, urinary tract infection, inflammation, or trouble with urination.
Diagnosis/Evaluation
- What to know before your visit:
- During your visit your doctor will ask you questions regarding your medical history and will perform an exam with focused attention to the abdomen and genitalia. Additionally, a digital rectal examination to feel the prostate will often be performed. Information regarding PSA history, personal and family cancer history, and voiding complaints will also be discussed.
- Tests that may be performed during or after your visit:
- Urinalysis: this evaluates for any blood in the urine or infection
- Post-void residual: The physician will often ask you to void and then check to make sure you are emptying your bladder.
- Imaging may be performed: An MRI Prostate involves an MRI of the pelvis and prostate. It may include contrast material and may involve placement of a probe into the rectum to aid in taking pictures of the prostate (but not always). The procedure typically lasts 30-45 minutes.
- Additional Blood work will often be performed
- Prostate needle biopsy (see below)
Treatment
Prostate needle biopsy:
- Transrectal prostate biopsy: This involves placement of an ultrasound probe into the rectum. We then measure the size of the prostate, provide local anesthetic, and perform biopsies of the prostate (typically 12 biopsies, but occasionally more). The procedure lasts approximately five minutes.
- Transperineal prostate biopsy: This involves placement of an ultrasound probe in the rectum. However, instead of taking biopsies through the rectum, biopsies are taken through the skin located between the scrotum and the rectum (typically 12 biopsies are taken, but occasionally more). The procedure lasts approximately 10-15 minutes. This has been associated with lower infection rates and higher cancer detection rates.
Schedule an appointment with a MidLantic Urology physician near you today!