What Is A Normal Psa Test Result
There is no specific normal or abnormal level of PSA in the blood, and levels may vary over time in the same man. In the past, most doctors considered PSA levels of 4.0 ng/mL and lower as normal. Therefore, if a man had a PSA level above 4.0 ng/mL, doctors would often recommend a prostate biopsy to determine whether prostate cancer was present.
However, more recent studies have shown that some men with PSA levels below 4.0 ng/mL have prostate cancer and that many men with higher levels do not have prostate cancer . In addition, various factors can cause a mans PSA level to fluctuate. For example, a mans PSA level often rises if he has prostatitis or a urinary tract infection. Prostate biopsies and prostate surgery also increase PSA level. Conversely, some drugsincluding finasteride and dutasteride , which are used to treat lower a mans PSA level. PSA level may also vary somewhat across testing laboratories.
Another complicating factor is that studies to establish the normal range of PSA levels have been conducted primarily in populations of White men. Although expert opinions vary, there is no clear consensus regarding the optimal PSA threshold for recommending a prostate biopsy for men of any racial or ethnic group.
In general, however, the higher a mans PSA level, the more likely it is that he has prostate cancer. Moreover, a continuous rise in a mans PSA level over time may also be a sign of prostate cancer.
How The Prostate Changes As You Age
Because the prostate gland tends to grow larger with age, it may squeeze the urethra and cause problems in passing urine. Sometimes men in their 30s and 40s may begin to have these urinary symptoms and need medical attention. For others, symptoms aren’t noticed until much later in life. An infection or a tumor can also make the prostate larger. Be sure to tell your doctor if you have any of the urinary symptoms listed below.
Tell your doctor if you have these urinary symptoms:
- Are passing urine more during the day
- Have an urgent need to pass urine
- Have less urine flow
- Feel burning when you pass urine
- Need to get up many times during the night to pass urine
Growing older raises your risk of prostate problems. The three most common prostate problems are inflammation , enlarged prostate , and prostate cancer.
One change does not lead to another. For example, having prostatitis or an enlarged prostate does not increase your risk of prostate cancer. It is also possible for you to have more than one condition at the same time.
Questions You May Want To Consider Asking Your Doctor Include:
- What type of prostate problem do I have?
- Is more testing needed and what will it tell me?
- If I decide on watchful waiting, what changes in my symptoms should I look for and how often should I be tested?
- What type of treatment do you recommend for my prostate problem?
- For men like me, has this treatment worked?
- How soon would I need to start treatment and how long would it last?
- Do I need medicine and how long would I need to take it before seeing improvement in my symptoms?
- What are the side effects of the medicine?
- Are there other medicines that could interfere with this medication?
- If I need surgery, what are the benefits and risks?
- Would I have any side effects from surgery that could affect my quality of life?
- Are these side effects temporary or permanent?
- How long is recovery time after surgery?
- Will I be able to fully return to normal?
- How will this affect my sex life?
- How often should I visit the doctor to monitor my condition?
Related Resources
How Might An Enlarged Prostate Affect My Life
Having an enlarged prostate affects men in different ways. Some men can manage mild symptoms and dont need treatment. Other men find they need to stay near a toilet. This can make it difficult to work, drive, be outdoors and attend social events. If you need the toilet a lot during the night, this can affect your sleep and make you feel more tired during the day.
Some men with an enlarged prostate find their symptoms improve over time without treatment. But for most, the symptoms will stay the same or slowly start to cause more problems over time unless they have treatment.
Can You Get Erections After Prostate Cancer Treatment
editorial processMedical Review Board
If you have ever wondered whether you’ll be able to have an erection after prostate cancer treatment, you are not alone. Many men who are facing a prostate cancer diagnosis, or who have undergone prostate cancer treatment, are worried about whether or not they will be able to have an erection after prostate cancer.
Surgical Treatment For Enlarged Prostate
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Transurethral resection of the prostate . In this surgery, the inner portion of the prostate is removed. Used 90% of the time, this is the most commonly used surgical procedure for BPH.
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Open prostatectomy .The surgeon makes an incision and removes the enlarged tissue from the prostate.
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Laser surgery –Laser surgery uses laser energy to destroy prostate tissue and shrink the prostate.
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Transurethral incision of the prostate .This surgery does not involve removing prostate tissue. A few small cuts are made in the prostate gland to reduce the prostate’s pressure on the urethra, making urination easier.
Medications For Enlarged Prostate
There are two main classes of pharmaceuticals that work to alleviate enlarged prostate symptoms: alpha blockers and alpha reductase inhibitors
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Alpha Blockers. Alpha blockers relax the smooth muscle around the bladder neck and within the urethra.
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Inhibitors. Inhibitors stop the conversion of the male hormone testosterone to DHT to reduce the prostate’s size, eliminating blockage.
Dont be surprised if your physician prescribes a combination of the two medications, as they have been shown to work more effectively together than alone. The downside is that combination therapy may increase the likelihood of experiencing side effects from the medications. Be sure to work with your doctor to assess the benefits and costs before starting on combination therapy.
What Are The Side Effects Of Treatments For Prostate Problems
The side effects of treating prostate problems may include the following:
- The medicines you take for prostatitis and BPH may make you feel sick or uncomfortable. Tell your doctor right away if you think the medicine is causing you to feel this way.
- Surgery for BPH may have a temporary effect on your ability to have sex. Most men recover their ability to have sex within a year of surgery. The exact length of time depends on the type of surgery and how long you had symptoms before surgery.
- You also may have bladder control problems after treatment for BPH. In most cases, these problems go away after several months.
If you have any problems after treatment for prostate problems, talk with your doctor. Chances are good that your doctor can help you.
If your doctor removes your prostate, youre more likely to have long-lasting problems with bladder control and having sex. Your doctor can recommend the best treatment options for these problems.
Do Prostate Problems Cause Other Problems
Yes, a prostate problem may cause other problems, such as
- problems having sex
- feeling stressed due to chronic pain
- inflammation in areas near your prostate
- bladder stones
- kidney failure
Which problem you may get depends on the type of prostate problem you have. Other problems may vary from man to man for each type of prostate problem.
Possible Cancer Protection From Prostate Drugs
Early research suggested that 5-alpha-reductase inhibitors , a class of drugs used to treat prostate enlargement, might increase the risk of developing more aggressive prostate cancer. However, newer studies have found that not only do the drugs appear to pose no extra risk, they may even protect against prostate cancer.
For instance, research from the Prostate Cancer Prevention Trial study in 2013 showed that taking the 5-ARI finasteride for seven years could lower the chance of getting low-grade prostate cancer by 25% among men ages 55 and older. A follow-up study of almost 9,500 men, published in the Nov. 1, 2018, issue of the Journal of the National Cancer Institute, also showed that finasteride lowered the risk by a similar amount , and found the protective effect lasted for at least 16 years.
What Is Your Prostate And What Does It Do
Your prostate is a small gland that lives inside your body, just below your bladder. It sits around the urethra, which is the tube that carries pee from your bladder through your penis. Only men have a prostate.
Your prostate produces some of the fluids contained in your semen, the liquid that transports sperm. This liquid contains special enzymes and hormones that help your sperm cells function properly, which means the prostate plays a key part in your fertility. The muscles in your prostate also help push semen through your urethra when you ejaculate.
Psa Screening Blood Test
A Prostate-specific antigen is made by the cells of the prostate gland. PSA testing is a common method to test for prostate cancer. PSA is found in semen, with a small amount in the blood. Men without prostate cancer often have PSA levels under 4 nanograms per milliliter of blood. Elevated PSA level increases the likelihood of having prostate cancer .
The American Cancer Society reports that men with a total PSA level of between 4 and 10 have roughly a 1 in 4 chance of having prostate cancer. With a total PSA of over 10, the chance of having prostate cancer rises to over 50%. Following the PSA test, if the levels are high, a doctor may suggest a repeat screening test or a prostate biopsy.
In addition to prostate cancer, there are many other factors that can affect a mans PSA levels.
Reasons for a High PSA:
Reasons for a Low PSA:
What Other Problems Might An Enlarged Prostate Cause
A small number of men may find it difficult to empty their bladder properly this is called urine retention. If youve been diagnosed with an enlarged prostate, your doctor will look at your test results to see if youre at risk of urine retention. You may be more likely to get urine retention if:
- youre aged 70 or over
- your prostate is very large
- you have a raised prostate specific antigen level
- you have severe urinary symptoms and a very slow flow.
Chronic urine retention
This is where you cant empty your bladder fully, but can still urinate a little. It usually develops slowly over time. Chronic means long-lasting. The first signs often include a weak flow when you urinate, or leaking urine at night. You may feel that your abdomen is swollen, or that youre not emptying your bladder fully.
Chronic urine retention is usually painless. But the pressure of the urine can slowly stretch your bladder muscle and make it weaker. This can cause urine to be left behind in the bladder when you urinate. If you dont empty your bladder fully, you might get a urine infection, need to urinate more often, leak urine at night, or get painful bladder stones. You might also see some blood in your urine. Chronic urine retention can damage your bladder and kidneys if it isnt treated.
There are treatments for chronic urine retention, including:
- passing a thin, flexible tube called a catheter to drain urine from your bladder
- surgery to widen the urethra.
Acute urine retention
What Are The Benefits Of Prostate Massage Therapy
Prostatic massage is thought to help clear the prostatic duct. This duct, or pipeline, runs between your prostate and the rest of your reproductive and urinary system. Massaging may produce a spontaneous secretion of fluid. This secretion may help clear this duct of any fluids. This could help eliminate any symptoms youre experiencing.
Medical research findings dont widely support the use of prostate massage. Most reports of prostate massages benefits are anecdotal or result from
studies that have looked at the use of prostate massage have been very small and not decisive. For that reason, some doctors may not support the use of prostate massage.
However, certain groups of men may benefit from prostate massage. Men with the following conditions may find symptomatic relief when they use prostate massage:
A Guide To Prostate Massage
editorial processCaitilin Kelly, MD
Caitilin Kelly, MD, is a clinical physician at Indiana University Health Bloomington Hospital and is board-certified in internal medicine.
Prostate massage is a procedure in which a finger is inserted into the rectum to stimulate the prostate gland. The goal is to release excess seminal fluidthe fluid that mixes with sperm to create semenfrom the ducts of the prostate gland.
Alternative medical practitioners claim that prostate massage can ease prostate inflammation while alleviating pressure on the urinary tract. Among the conditions prostate massage is said to treat are:
- Benign prostatic hyperplasia : enlargement of the prostate
- Prostatitis: inflammation of the prostate
- Urinary hesitancy: difficulty urinating
- Erectile dysfunction: difficulty getting or keeping an erection
Prostate massage is also used for sexual stimulation to help achieve arousal, enhance an erection, or relax the rectum in advance of anal sex.
This article will discuss the medical and sexual purposes of prostate massage. It also covers how the procedure is done, along with the risks and side effects that may come with it.
Have A Partner Help You
Unless youre extremely flexible, its a little bit awkward stimulating yourself. Its by no means impossible, but it can be tough to relax while you’re bent like a pretzel. Thats why its a good idea to have your partner help you out. It also feels much better! When someone else is doing the work for you, you can focus on your breathing, the sensation, and everything else happening to your body.
How Is Bph Treated
In some cases, in particular where symptoms are mild, BPH requires no treatment. At the opposite extreme, some men require immediate intervention if they cannot urinate at all or if kidney/bladder damage has occurred. When treatment is necessary, many men will simply require daily medication. If this fails to completely treat the symptoms, or if there are signs of damage from BPH, the doctor may recommend minimally invasive endoscopic surgery . Or, in some cases, traditional surgery may be recommended.
- Drug treatment: The FDA has approved several drugs to relieve common symptoms associated with an enlarged prostate, including drugs that inhibit the production of the hormone DHT and drugs that relax the smooth muscle of the prostate and bladder neck to improve urine flow.
For surgery, there are many procedures to choose from, and the choice depends largely on your specific prostate anatomy, and surgeon preference and training. These procedures all have a common goal of widening the urethral channel as it passes through the prostate. Procedures include the following:
Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
What Are Enemas Used For
Enemas can be used for several situations or conditions. These include:
Constipation. If youve tried other constipation remedies unsuccessfully, your healthcare provider may suggest an at-home enema. The flow of fluid through your lower colon may stimulate the muscles to move the impacted stool.
Pre-procedure cleanse. Your healthcare provider may ask you to do an enema in the days or hours before a procedure like a colonoscopy. This helps ensure that theyll have an unobstructed view of your colon and tissues. It will make spotting polyps easier.
Detoxification. Some people promote enemas as a way to cleanse your colon of impurities, bacteria, and buildup that may make you sick. However, there isnt any scientific evidence to support the use of enemas for this reason. Your colon and other GI tract structures efficiently clean themselves thats why you produce waste.
Two primary types of enemas exist: cleansing and barium.
How To Check Your Prostate
This article was co-authored by Robert Dhir, MD. Dr. Robert Dhir is a board certified Urologist, Urological Surgeon, and the Founder of HTX Urology in Houston, Texas. With over 10 years of experience, Dr. Dhirs expertise includes minimally-invasive treatments for enlarged prostate , kidney stone disease, surgical management of urological cancers, and mens health . His practice has been named a Center of Excellence for the UroLift procedure, and is a pioneer in non-surgical procedures for ED using his patented Wave Therapy. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology. Dr. Dhir served as chief resident during his urological surgical residency at University of Texas at Houston / MD Anderson Cancer Center in addition to completing his internship in general surgery. Dr. Dhir was voted Top Doctor in Urology for 2018 to 2019, one of the top three Best Rated Urologists in 2019 & 2020 for Houston Texas, and Texas Monthly has named him to the 2019 & 2020 Texas Super Doctors Rising Stars list.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article has 11 testimonials from our readers, earning it our reader-approved status. This article has been viewed 1,025,150 times.
Getting A Prostate Biopsy
For some men, getting a prostate biopsy might be the best option, especially if the initial PSA level is high. A biopsy is a procedure in which small samples of the prostate are removed and then looked at under a microscope. This test is the only way to know for sure if a man has prostate cancer. If prostate cancer is found on a biopsy, this test can also help tell how likely it is that the cancer will grow and spread quickly.
For more details on the prostate biopsy and how it is done, see Tests to Diagnose and Stage Prostate Cancer.
For more information about the possible results of a prostate biopsy, see the Prostate Pathology section of our website.
What Is Benign Prostatic Hyperplasia
Benign prostatic hyperplasia , or benign prostatic hypertrophy, is an enlargement of the prostate, a walnut-sized gland that forms part of the male reproductive system. During ejaculation, the prostate secretes fluid into the urethra, the narrow tube that runs through the center of the prostate. When a man urinates, the bladder squeezes urine out through the urethra.
As a man ages, the prostate can become enlarged. Because it surrounds the urethra right at the bladder exit, the prostate may squeeze or pinch the urethra as it gets larger over time. This may cause difficulty with urination such as a slow stream, the need to strain, increased frequency, urgency to urinate, incomplete emptying of the bladder, and intermittent flow or dribbling.
BPH is the most common disorder of the prostate gland and the most common diagnosis by urologists for males between the ages of 45 and 74. More than half of men in their sixties and as many as 90 percent in their seventies and eighties have some symptoms of BPH.
Although research has yet to pinpoint a specific cause for BPH, theories focus on hormones and related substances like dihydrotestosterone , a testosterone derivative in the prostate that may encourage the growth of cells.
Tests Used To Check The Prostate
This first step lets your doctor hear and understand the “story” of your prostate concerns. You’ll be asked whether you have symptoms, how long you’ve had them, and how much they affect your lifestyle. Your personal medical history also includes any risk factors, pain, fever, or trouble passing urine. You may be asked to give a urine sample for testing.
Why Are Prostate Exams Performed
A lot of men do not realize the importance of a frequent prostate exam. When a man goes for a general check-up with his doctor, a prostate exam may be advised. This is considered part of a general health check-up.
It is generally advised that men undergo frequent health screenings once they reach the age of 40 . Research shows that this is the time when the risk of several prostate conditions increases.
For this reason, after 40, a man should ensure they obtain a prostate exam as part of their health screening.
The main reason why a doctor may advise on a prostate exam is to feel for any abnormalities with the mans prostate. This helps detect prostate disease. It is usually possible for a doctor to determine the health of the mans prostate through this examination. Further testing may be needed too.
The doctor can detect different prostate problems through a prostate exam. It is often considered the initial diagnostic option. The prostate exam itself can give a doctor an indication if there is an enlargement or swelling in the prostate gland. It also helps to determine prostate health.
In most cases, a prostate exam alone will not be the only diagnostic tool. After a digital rectal exam is done, the doctor will order additional tests if abnormalities are identified. This will help to diagnose problems like cancer and prostate enlargement.
Generations Of Men Underwent Prostate Cancer Tests During An Aggressive Screening Regimen Then The Screenings Stopped Now Doctors Are Reevaluating Just How Worried Men Should Be About Their Prostate
Its tucked deep within the body, nestled between the bladder and penis, an elusive gland roughly the size of a Ping-Pong ball. Many people dont know what, if any, purpose the prostate serves most of what we hear about it revolves around the problems it can cause, especially later in life. But without it, there might not be any life at all.
In some ways, the male prostate gland is equivalent to the female mammary glands. Mammary glands are responsible for nourishing a child in the early stages of life; the prostate is responsible for protecting the sperm even earlier. It does this by producing an enzyme called prostate-specific antigen , which liquefies the semen, essentially freeing it from the seminal coagulum. PSA also gets credit for neutralizing the cervixs blocking enzyme, which allows sperm to freely enter the uterus and, hopefully, penetrate the egg.
The prostate gland, small as it is, is like a multifaceted diamond: every time you look at it from a different angle, under a different light, you see a different aspect of it, find a new scientific challenge, unresolved mysteries, says urologist Dr. Claus Roehrborn, who specializes in prostate diseases and has chaired the University of Texas Southwestern Medical Center Department of Urology since 2002. His work is at the forefront of current innovations in treating and diagnosing prostate cancer.
How Radical Prostatectomy Affects A Relationship
A 2011 study of 63 men that had undergone a radical prostatectomy found that about 75 percent of them sought treatment for erectile dysfunction. Additionally, more than 50 percent reported having less sexual desire, and roughly an additional 40 percent were unable to have a satisfying orgasm.
The mental health effects of these symptoms were worse in highly sexually motivated participants. 52 percent reported that this had affected their self-esteem, and 36 percent said having performance anxiety.
Additionally, the last three items on the list above can be show-stoppers for a relationship. Few women can tolerate a high degree of urine leakage during sexual activity, and few men can handle the pain during intercourse.