Most men who present with a lower urinary tract infection will have an elevated PSA level at the time. Although this elevation will usually be due to inflammation, it is important to consider other possible causes for the patient’s symptoms and PSA level.
An active 62-year-old barrister presented as a new patient with increasingly bothersome lower urinary tract symptoms (LUTS). These consisted mainly of urgency and a weak stream, and had been worsening over the past few months. He had attended another doctor recently, who had ordered a prostate specific antigen (PSA) test (54.5 ng/mL) and a midstream urine (MSU) test (normal) and diagnosed prostatitis. The patient was treated with a course of antibiotics, which did not have any obvious effect on the symptoms.
Is there anything in this scenario that worries you?
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