CAn PSA be elevated by Hernia Surgery

I am 61 and in good health.  I have longstanding BPH and have been followed with yearly digital exams and PSA.  My PSA has been up and down over the years with Free PSA checked after higher values.  My Dad had prostate CA at age 75.  My younger brother who also has lonstanding BPH had high PSA's and 4 years ago when it was over 8 he had a biopsy;  it was negative for cancer and positive for prostatitis.  My urologist has always described my prostate as large but very smooth.  My PSA levels 8/02=4.5 (free >25%), 9/02=3.5, 3/03=5.4 (free>25%), 4/03=3.8, 2/04=2.7, 3/05=3.8, 1/06=3.2, 2/07=4.0, 2/08=3.4, 6/09=4.0, 5/10=3.3, 9/11=4.8, 1/12=5.4 (free=24%).  I had an inguinal hernia bothering me for several months and had a repair done on 2/17/12 and had a lot of pain and swelling (I'm still not fine but better).  On 2/29/12 I had a PSA of 6.7nd my urologist said I should probably have a biopsy.  I have scheduled it but am terrified.  My question is :  Is it possible that the hernia and especially the surgery have elevated the PSA.  I also have had night sweats of and on for about 5 months which have improved lately (my brother told me that was the main symptom of his prostatitis.  I also have what some would consider excessive sex.  I know I may be looking for excuses but knowing the uncertainty of this whole area is there any case to be made for not having a biopsy.

[S. Kaul, MD]

Hi there!

A hernia is unlikely to be responsible for the elevated PSA level though inflammation of the prostate could be responsible. With a mildly elevated PSA level and high percent free PSA the risk of cancer is low, though a biopsy may be recommended with constantly high values to be on the safer side.
Hope this is helpful.

Take care!

[goliath415]

Thanks, I hope it's the right thing to do since I'm having the biopsy today.  I did have one more level 3 weeks after the 6.7 (last week) and it had dropped to 5.8 (19% free) but my urologist still felt I should have a biopsy.  So here goes nothing.