psa results

[razor48]

Every year I schedule my appointment with my GP and Urologist on concurrent days. They are in different cities, 30 miles apart.
On 2/17 I had my annual appointment with my GP strictly for metabolic and lipid profiles. I have a psa done for comparison. My GP does not do a DRE. There was no sexual activity for several days prior to appointments.
A couple of days later I found out my psa was 4.24.
The next day, 2/18, I had my annual appointment with my urologist. He performed a DRE and told me my prostate was enlarged. My psa was 2.88.

Below are my psa's for comparison.

2007
Urologist:1.87   GP: 2.42
2008
Urologist:1.57   GP: 2.07
2009
Urologist: 1.81  GP: 2.28
2010
Urologist: 2.88  GP: 4.24

My questions are what is to be made of the difference one day apart? Can BPH increase psa 1 or 2 pts?
I have taken saw palmetto for years. What is your advice?
Thank you.

[Stephen Liroff, MD]

I assume that your urine was not infected and that you were not taking any antibiotics. PSA results from different labs cannot be compared except in gross sense. There are definite differences. That being said, 4.24 is vastly different than 2.88 and has me concerned. Certainly PSA's can differ between days, also, but again this is quite a difference. I think that you should have your PSA repeated through your urologist in another 2 months and discuss the numbers with him/her.
Saw Palmetto is a reasonable drug to decrease mild urinary frequency/night time urinating. Other than these  effects, I do not see a place for this.
Good luck!
S.A. Liroff, M.D.

[razor48]

I failed to mention I am 61 yrs. old.
razor 48