Elevated PSA

A PSA test measures the level of prostate-specific antigen, a protein produced by the prostate gland. The prostate, located below the bladder, contributes to seminal fluid that supports sperm function. While PSA is primarily present in semen, small amounts circulate in the bloodstream.

Elevated PSA in the blood can signal changes in prostate health, prompting further evaluation to determine whether the cause is benign or requires treatment.

Elevated PSA levels do not always produce noticeable symptoms, but when present, signs may include:

• Difficulty urinating or weak urine stream

• Increased urinary frequency, particularly at night

• Pelvic or lower back discomfort

• Blood in the urine or semen

• Erectile or sexual dysfunction

It is important to note that many men with elevated PSA have no symptoms at all, making routine screening especially valuable.

Elevated PSA may result from a range of conditions, including:

• Prostate Cancer – Cancerous cells in the prostate can produce higher PSA levels.

• Benign Prostatic Hyperplasia (BPH) – A non-cancerous enlargement of the prostate, often occurring with age.

• Prostatitis – Inflammation or infection of the prostate, which may lead to urinary symptoms or pelvic discomfort.

Non-disease-related factors can also temporarily raise PSA, such as:

• Strenuous exercise (e.g., cycling)

• Sexual activity within 48 hours before the test

• Recent bowel movements

• Digital rectal exam performed shortly before the blood draw

Because multiple factors can affect PSA, accurate interpretation requires a comprehensive clinical evaluation

At Advanced Urology Centers of New York (AUCNY), our urologists use a comprehensive approach to evaluate elevated PSA, which may include:

• Medical history and physical examination – including family history, lifestyle factors, and a digital rectal exam

• Repeat PSA testing – monitoring changes in PSA over time

• Urine testing – to rule out infection or inflammation

• Advanced imaging – ultrasound, CT, MRI, or PET scans to provide detailed views of the prostate

• Prostate biopsy – if indicated, a tissue sample may be taken to confirm or rule out cancer

Treatment for elevated PSA depends on the underlying cause:

• Prostate cancer – management may include active surveillance, surgery, radiation therapy, or other advanced treatments

• BPH (enlarged prostate) – options may include lifestyle changes, medication, or minimally invasive procedures

• Prostatitis – treated with antibiotics, anti-inflammatory medications, or other supportive therapies

• Temporary elevations – if caused by exercise, sexual activity, or other non-disease-related factors, no treatment may be needed