My husband is 51 yrs old. Healthy. Has had microhematuria since 2003. No WBC or bacteria on most of annual urinalyses. No other symptoms.
In 2007 he had IVP; in 2011 he had renal ultrasound, ab CT scan, cytology, and cystoscopy, all were negative.
PSA history: 0.5 (2010); 0.5 (2011); 0.7(2012)
%fPSA was 14% based on PSA=0.7 (2012)
Testosterone was 450 (2011).
DRE: Dec 2011-"slightly firmer along right edge, not completely normal; less than 10% chance of prostate cancer". Repeated DRE 6 mo later, same firmness. Urologist wanted to have biopsy based on firmness and low %f PSA. After prostate massage, urine has a bit WBC and RBC, no bacteria.
Went to see family doctor who prescribed 6 weeks of Bactrim DS, thinking it's prostatitis.
On day 30 on Bactrim DS, a urinalysis showed a bit of WBC, RBC, bacteria from skin contamination (not sensitive to Bactrim), no growth after culture.
Question (1) He just finished 6 wks of Bactrim treatment. Scheduled to have PSA test on next Thursday, which is 9 days after finishing with Bactrim, and 20 days after bacteria (skin contamination) found in urine. Is it too soon to have PSA test? When (in terms of weeks) will be better time to have PSA test done?
Question(2)-%fPSA is normally for PSA>2.5. Should I be concerned that his %fPSA is low (14%) based on PSA being 0.7 only?
Question(3)-should I push my husband to have biopsy? I don't want to have any delay.
Thank you so much for your time! I truly appreciate it!!
The PSA test can be taken after completion of the antibiotic course. A percent free PSA of 4% is in the intermediate range and may not be anything to be worried about still, though if the suspicion is high on imaging studies, a biopsy would be suggested. It would be best to discuss the situation with his treating urologist.
Hope this helps.
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