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sudden bouncing psa with prostatitis

I am a 62 year old male with a 30 year history of prostatitis with one acute outbreak 30 years ago and 3 in the last decade, previously antibiotics would clear the infection and life would go on...10 years ago following an outbreak I was put on floxin for 6 weeks which resolved the infection but left me with sensory impairment ever since. My psa has always been stable throughout these outbreaks with a baseline of 2.0. Prostate is only slightly enlarged at 23cc.
A year ago my urinary symptoms began to deteriorate. Thinking I had another bout of prostatitis I went for 3 prostate massages to see if this improved my situation. It did at first but then the syptoms got worse. I visited my MD. My psa had spiked from 2.0 the year before to 6.9. and my prostate was enlarged asymetrically on one side. A month later after being on cipro for 5 weeks, my psa came down to 3.0 and stayed there...a biopsy was performed and came back negative...following the biopsy I experienced considerable discomfort for several months with a further loss of sensory feelings during exjaculation...I was put back on various antibiotics for a further 3 months....the discomfort continued...with my MD's approval I went for 3 more prostate massages which did relieve the discomfort....my psa though began to bounce around and has remained unstable ever since...rising to 5.2 then back to 3.8 and most recently up to 4.5...my Uro tells me he is not worried about the bouncing PSA...and does not see a need for any further imaging...earlier ultrasound saw nothing suspicious. I am still on antibiotics as I write this, a year later. Other than a continued loss of sensory feeling (somewhat better than before though)...most of my symptoms have improved...my concern is around undetected PC. My Uro has asked me to return in 6 months for a follow up..that seems a long time to me. I would appreciate your opinion on these events, particularly as they relate to possible PC.
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Thanks for your comments.
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647273 tn?1292091141

I have had problems with prostatitis since I was about 19 years old, I'm 46 now.
In 2003 I was seen by a urologist with regards to sexual health as part of an observation for neurological problems.
I had been having problems with Ed for several years and all the oral meds did not help.
After some blood tests it was determined that I had low levels of testosterone. I had lost my left testicle in 2000 following a major infection.
To determine whether the testosterone levesl were right, I had my blood taken to determine levels of testosterone as well as PSA, since the testosterone can increase these levels.
On one occasion, the urologist phoned me to inform me that for my age the PSA levels were very high. After talking to me for a bit, I informed him that I had been hospitalized with a kidney infections. I was then told to repeat the tests to determine if the levels were elevated due to the infections that I had.
When my levels were taken things were still high but a lot lower than previous. When the tests were repeated once more the level were in the normal range.

Since you are still on antibiotics, it is possible that this is keeping the PSA levels high as your body is fighting an infection.

In my case I had a review with the urologist once a year or more if there were problems. For all other occasions, I relied on our family doctor.

Over the last few years my levels have been up and down again as I have a fistula between my prostate and rectum, most likely the result of self catheterization due to a neurogenic bladder. As a result I have had neumerous UTI. These infections causes the PSA readings to differ.

All the best,

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