Friday, April 12, 2013

SERUM PSA MORE THAN 100 ng/ml: A COMMON PRESENTATION OF ACUTE ON CHRONIC PROSTATITS

A 56 year old man presented to us with shivering and fever. He has lower urinary tract symptoms for 2 weeks and was put on prulifloxacin by a general practitioner.
We evaluated him  and found to have tender prostate on DRE. He was then catheterised with 14 Fr Silicon catheter.His hematological and biochemical tests revealed mild leucocytosis; rest all tests were normal.
He had a previous USG; which showed normal prostate size but Post Void Residual urine about 110 ml. His PSA was more than 100 ng/ml. We repeated the test again it was the same.




The patient was educated and once he knew about the high PSA value; he was panicky.As the PSA is invariably correlated with prostate cancer by the laymen.  
We counselled him that most likely it would be prostatic infection and went ahead with the TRUS guided biopsy after the culture report and treating him with IV antibiotics for 48 hours.
The biopsy was negative and revealed active prostatitis. We took him for LASER prostatectomy again after 48 hours of continuous IV antibiotics.


He is doing fine postoperatively.

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