An elevated prostate specific antigen (PSA) may be due to a number of conditions. Sometimes a patient may have more than one cause.
Causes of an elevated PSA:
(1) prostate cancer
(2) metastastic cancer involve the prostate
(3) benign prostatic hyperplasia (BPH)
(4) older age (possibly related to BPH)
(5) prostatitis
(6) digital prostate massage
(7) pelvic trauma or surgery
(8) indwelling urinary catheter
(9) ejaculation
(10) bicycle riding or other strenuous exercise
(11) urinary tract infection (UTI)
(12) malakoplakia of the prostate
If the cause is reversible, then the serum PSA should be lower 3-4 weeks after correction of the cause.
The increase in serum PSA seen with age and/or BPH is an argument for age or volume adjusted upper limits of normal for the serum total PSA.
