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Urology (Expert Forum)
DRE before PSA testing
Answered by
Stephen Liroff, MD - Urology, Pediatric Urology, Peyronie’s disease
Vattikuti Urology Institute, Henry Ford Hospital
West Bloomfield - MI
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
DRE before PSA testing
by Hector774, Jun 14, 2009 07:05PM
I am a 50 year old male and I take a prostate exam every year. My PSA in December of 2007
was .9 for some reason I waited until March 2009 to have my next prostate exam, my PSA went
up to 2.5. My urologist did not noticed this changed until almost a month later and his nurse
called me and stated that the Doctor was concerned because of the PSA rapid velocity and
wanted to do another PSA test, which is fine with me. I have read some of your articles and I
suspect this could be a false reading because of the following events: 1. I think I had some kind
of infection the previous week before the exam and had a hemorroid and took suppossitories to
get rid of it before the exam. 2. ALSO, for some reason the nurse forgot to draw blood before
the DRE, and after the doctor performed the DRE he asked me if the nurse have drawn blood for
the PSA and I said no, then he send the nurse to draw blood for the PSA TEST after the DRE.
When the nurse called me to let me know that the doctor wanted to do another PSA test, I told
her that if the results could have been affected because of the PSA test after the DRE, she got
upstet and stated that it had nothing to do whether is before or after the DRE. 3. And last but
not least, I heard about the relationship of high cholesterol and PSA levels. In Jan 2008 I decided
not take my cholesterol medication and when tested my tryglocerides went up from 78 to 207.
Could all these incidents caused my PSA level to increase from .9 to 2.5 in a period of 18 months.
Thank you for your prompt assistance.
Concerned male
was .9 for some reason I waited until March 2009 to have my next prostate exam, my PSA went
up to 2.5. My urologist did not noticed this changed until almost a month later and his nurse
called me and stated that the Doctor was concerned because of the PSA rapid velocity and
wanted to do another PSA test, which is fine with me. I have read some of your articles and I
suspect this could be a false reading because of the following events: 1. I think I had some kind
of infection the previous week before the exam and had a hemorroid and took suppossitories to
get rid of it before the exam. 2. ALSO, for some reason the nurse forgot to draw blood before
the DRE, and after the doctor performed the DRE he asked me if the nurse have drawn blood for
the PSA and I said no, then he send the nurse to draw blood for the PSA TEST after the DRE.
When the nurse called me to let me know that the doctor wanted to do another PSA test, I told
her that if the results could have been affected because of the PSA test after the DRE, she got
upstet and stated that it had nothing to do whether is before or after the DRE. 3. And last but
not least, I heard about the relationship of high cholesterol and PSA levels. In Jan 2008 I decided
not take my cholesterol medication and when tested my tryglocerides went up from 78 to 207.
Could all these incidents caused my PSA level to increase from .9 to 2.5 in a period of 18 months.
Thank you for your prompt assistance.
Concerned male
Doctor's Answer
by Stephen Liroff, MD, Jul 04, 2009 01:01AM
, Jul 04, 2009 01:01AM
Hi! I have obviously been out of touch with the web site for the last 2 ½ weeks. Sorry if I increased your anxiety. Do not blame Med Help.
PSA’s do bounce around a bit and in my opinion need to be repeated before making decisions based upon them. If the repeat comes back normal, then I would get a follow-u[ one in three months: who is to say which of the first two is the right one?
The closeness in time between getting your rectal exam and the blood test would not matter. PSA would not go up that quickly. I do suggest that you not have an orgasm for the three days before your repeat study.
The relationship between PSA and cholesterol is not firm at this point, but certainly you cannot assume that an elevated PSA or PSA kinetics are due to the cholesterol and not a prostate cancer. If your PSA is rising too rapidly or is persistently elevated, then you need to have a prostate biopsy.
Good luck!
S.A.Liroff, M.D
PSA’s do bounce around a bit and in my opinion need to be repeated before making decisions based upon them. If the repeat comes back normal, then I would get a follow-u[ one in three months: who is to say which of the first two is the right one?
The closeness in time between getting your rectal exam and the blood test would not matter. PSA would not go up that quickly. I do suggest that you not have an orgasm for the three days before your repeat study.
The relationship between PSA and cholesterol is not firm at this point, but certainly you cannot assume that an elevated PSA or PSA kinetics are due to the cholesterol and not a prostate cancer. If your PSA is rising too rapidly or is persistently elevated, then you need to have a prostate biopsy.
Good luck!
S.A.Liroff, M.D
