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Is PSA Level Of 49 A Cause For Concern?

Posted on Mon, 14 Sep 2015

Question: I have recurrence UTI problem. previously there was bleeding with E coli infection. PSA level increased to 49. After taking antibiotic PSA level became normal <4. Flexible cystoscopy result. Prostrate size normal, high up bladder neck. Bladder neck diliated . After that frequent Ecoli infection is there. Now adays I am taking Tracfree , Flotral D. Urine flow normal 29/896.Kindly advice so that I can lead healthy life

Answered by Dr. Dr. P. T. Patil (43 minutes later)

Brief Answer:
Continue taking medications

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have recurrent UTI

I shall be happy if you can post me few more details to help me in making comments on your problem
1) Have you done all the tests advised by your Urologist and is it possible to upload reports of these tests .
2) Have you ever done ultrasound Scanning of abdomen and pelvis and what is the post void urine volume reported ?
3) Have you done urine culture and taking antibiotics as per culture report.?

The recurrent UTI at this age is likely to be due Bladder Outlet Obstruction You have mentioned your bladder neck to be raised and bladder neck dilated which is contradictory .

Hoping to get feedback from you to help me to make precise comments and suggestions.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

1. Cystoscopic report on Nov'14: Urethra normal,small prostrate with high up bladder neck, No mucosal lesion in bladder, BUO-normal with nomal efflux of urine, no bleeding point noted.
2.USG KUB before cystoscopy in Nov'14: right kidney 10.2 cm, left kidney 10.5 cm, an anechoic corticalcyst measuring 2.4 X 2.2 cm in left kidney, interpolar region, PVR 17 cc app,prostrate 14 gms app
Antibiotic used Alevo 750 once daily for 7 days

April 2015 E coli infection
1. Urine routine test: pus cell 1-3, red blood cell absent,
Urine culture: E coli, Azithromycin sensitive

2. PSA 12.21

3. USG KUB: Kidneys are normal in shape and size, cortical cyst 24X21 mm size, PVR 6 cc,prostrate 18.3 gms
Antibiotic Aziwok taken as per doctor's advice
PSA reduced to 0.75
July 2015 E coli infection
1. Urine culture:E coli. sensitive-Amikacin,Gentamycin,
Urine routine pus cell :1-2, red blood cell not detected

2. PSA -0.48

medicine percin 600 once daily for 5 days, tracfree once daily, Flotral D once daily
after taking medicine
Uroflowmetry: XXXXXXX flow rate: 29 ml/s, voided volume 896 ml.
Urine culture: No growth of bacteria
USG KUB: Kidneys are normal size and shape. Cortical cyst in left kidney 2.3X2.5 cm
PVR 72 cc
Prostrate: 17.3 gms.

Now experiencing burning sensation sometimes, worried about E coli once again,
medicine: tracfree, Flotral D
Hope these informations will help to diagnosis more accurately

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
Nothing to be worried about.

Detailed Answer:
Hello
Thanks for uploading all the reports and details about the treatment taken,

You have repeated episodes of E-Coli infection which needs to be monitored by frequent routine urine test and urine culture and take appropriate antibiotics ( If required)..There is no obvious cause detected for getting repeated UTI.
Thanks and regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (2 hours later)

should I continue 1) tracfree
2) Flotral D.
in case of emergency what antibiotic I should take? I am staying in aremote place.

Answered by Dr. Dr. P. T. Patil (25 minutes later)

Brief Answer:
You can continue taaking both the drugs .

Detailed Answer:
Hello
Thanks for follow up .
Tracfree is a Canbury preparation and helps to prevent infection in bladder .There is no harm in taking for a longer period .

Flotral helps to improve urine flow .You can take it as long as you have weak urine flow .

You can keep tab Cefixime with you as a emergency .

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar