Hi,
Though, an immediate substantial increase in level of PSA after prostatic
biopsy or TURP is usually present, however, usually there is no increase or very minimal increase in PSA level after
cystoscopy. Any how, these levels, usually come to normal within 3 weeks. Though, your level, has come to your previous level of 4.7 after 10 months or so, still you are required to continue
Veltam for more time till PSA level comes back below 4.0 and you are not having any urinary symptom of slow flow or dripping etc.
However, as you are still having your PSA level >4.0, this is an indication of prostatic biopsy. There is always an indication of prostatic biopsy if:
- PSA level is >4.0
- PSA level is increasing
-If free PSA is very less as compared to total PSA. Lower level (- If on
digital rectal examination, the
prostate is having a hard and lumpy feel, this is also an indication for prostatic biopsy.
Therefore, in all above indications, prostatic biopsy is always advisable to confirm or rule out the presence of prostatic cancer.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Satnarain Bansal, General & Family Physician