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Normal Psa, Frequent Urination With Blood In It. What Is The Possible Disease?

Posted on Tue, 7 May 2013

Question: Is it likely that you can have bph even with normal psa level?... My Daddy's psa level is normal but he is seeing blood in his urine. It usually starts with a little blood and clears up as he urinates! The first time was about three months ago and then he went a few weeks before it happened again. It happened a total of about four to five times in the three months but it has happened three or four times in the past two weeks. The doctors did not know about this when they gave him his checkup-but his psa level was GOOD! He says he has no discomfort but frequently has to use the bathroom and weak urine flow. Thank-you!

Answered by Dr. Dr. P. T. Patil (1 hour later)

Hello,

Thanks for your query.

Based on the facts that you have posted it appears that your father who is 66 years old has frequency of urination and weak stream and repeated episodes of hematuria .This is suggestive of Benign Enlargement of Prostate ( BEP)

Serum PSA is raised in malignancy of the prostate (Cancer of the prostate) and normal in BEP.

Please consult qualified Urologist for clinical and digital rectal examination and get following preliminary investigations done to confirm the diagnosis.
1) Routine Urine Test.
2) Ultrasound scanning of the abdomen to know the size of the prostate.
3) Uro flowmetry to know the average urine flow per second while urinating.
He may need to get endoscopic examination of the Bladder (Cystoscopy) done to rule out other cause for Hematuria.(Any malignancy in the bladder).

Hope I have answered your query.

Please feel free to ask if you have any more questions I shall be happy to help you.
Thanks with Regards.
Dr.Patil..

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. P. T. Patil (21 hours later)

Thank-you so much! What would be the reason for him to see blood some days and not on others? Is this a good sign or does this matter either way? Thanks again!

Answered by Dr. Dr. P. T. Patil (2 hours later)

Hello
Thanks for follow up.
The cause of the bleeding is due to rupture of the superficial vessel on the surface of the prostate and due to secondary infection of the prostate ( Prostatitis) that is always associated with BEP.
However it it is always better to get Cystoscopy done to rule out other causes of bleeding .

Please consult qualified Urologist for assessment and to decide about future course of action and line of treatment.
Thanks and Regards.
Dr.Patil.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Prasad