What are the causes of a raised PSA?
Urinary tract infections.
Prostatic inflammation (prostatitis).
Ejaculation (within 48hrs before the test).
Vigorous exercise especially cycling (within 48hrs before the test).
Rectal examination of the prostate raises PSA slightly.
Procedures or investigations of the bladder and prostate including insertion of urinary catheter, prostate biopsy or cystoscopy (within 6 weeks before the test).
Prostate stimulation and receptive anal intercourse.
What if the PSA level is raised?
If the PSA level is raised, then you will require a comprehensive assessment with a full medical history, digital rectal examination (DRE) of the prostate and a urine test to rule out infection.
Further investigations will be dependent on your circumstances, and may include MRI scan (multi-parametric MRI) and transrectal ultrasound guided prostate biopsy.
Occasionally, prostate biopsy is also recommended if you have been told that the prostate feels abnormal regardless to the PSA level. It is important to know that a normal prostate biopsy does rule out prostate cancer completely, but makes it less likely.
Raised PSA (Prostate Specific Antigen)
What is PSA?
PSA is a protein that is produced by prostate cells only. The majority of PSA is secreted in the semen and its function is to keep the semen in a liquid form; small amounts of PSA can leak into the bloodstream. High level of PSA in the blood may indicate prostate cancer; however, many other conditions can also increase PSA level.
What is the normal PSA level?
There is no true cut off value for a normal PSA. PSA level increases slightly with age, and as a rough guide, the table below shows what is regarded as the upper normal values of PSA in different age groups:
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