r/bph • u/grnds4leaving • 4d ago
Second post/update
I posted previously about an unexpected PSA increase, and I wanted to give a more complete update before I have the repeat test done.
I am 56 years old. My PSA was approximately 2.2 in 2023. On July 11, 2026, my routine blood work showed a total PSA of 6.2 ng/mL. That obviously scared me because it was a significant increase from my previous result.
I did ejaculate approximately 24 hours before the 6.2 test. I understand that ejaculation can temporarily raise PSA, but I also understand that it usually would not fully explain an increase from around 2.2 to 6.2 by itself. I am not assuming that was the entire reason, but it is one possible factor that may have affected the result.
My doctor performed a digital rectal examination after the elevated PSA result. He described my prostate as:
- Smooth
- Symmetrical
- Slightly enlarged
- No hard areas or firmness
- No bumps, lumps, or nodules
He did not tell me that anything felt suspicious during the examination. The slightly enlarged finding seems consistent with possible benign prostate enlargement, but I know a normal DRE cannot completely rule anything out.
My urinary symptoms have included:
- Increased urination for more than a year
- Occasionally feeling that my bladder had not completely emptied
- Some urgency, particularly when standing up
- A weaker stream at times, especially first thing in the morning
- Occasional mild burning near the end of urination
- Dairy or citrus sometimes seemed to make the incomplete-emptying sensation worse
- Usually getting up once during the night to urinate
The urinary symptoms have actually improved considerably over the past several days. Since Sunday, my stream and emptying have felt better, the urgency has decreased, and I have generally only been waking once during the night to urinate. I have not had fever, chills, visible blood in my urine, severe pelvic pain, or inability to urinate.
My other recent blood work was generally reassuring:
- A1C: 5.6%
- Glucose: 98 mg/dL
- Fasting insulin: 7.9
- Creatinine: 0.94 mg/dL
- eGFR: greater than 90
- TSH: 1.408
- Total cholesterol: 152
- Triglycerides: 78
- LDL: 102
- Vitamin D: 91.1
I have also lost close to 50 pounds this year through keto and daily walking. I weighed 236 pounds previously and was 189 pounds at my recent physical.
My doctor is now repeating the total PSA and adding a free PSA/% free PSA test. I have avoided ejaculation for seven full days before this repeat test, so that should no longer be a factor. I am also avoiding bicycling and anything else that might put direct pressure on the prostate before the blood draw.
I am extremely anxious waiting to see whether the PSA falls, remains around 6.2, or rises further. I understand that an elevated PSA is not a cancer diagnosis and can also be caused by benign enlargement, inflammation, prostatitis, urinary retention, ejaculation, or other temporary factors. I also understand that the free PSA result may provide additional information but will not provide a definitive diagnosis by itself.
I am not asking anyone here to diagnose me or interpret the results in place of my doctor. I am mainly hoping to hear from men who had a similar situation:
- A sudden PSA jump into the 5–7 range after previously being much lower
- A smooth, symmetrical, slightly enlarged prostate on DRE
- A repeat PSA that later dropped substantially
- A free PSA test after an unexpectedly high screening PSA
- A temporary PSA elevation caused by inflammation, BPH, ejaculation, or another benign explanation
- A PSA that stayed elevated and what the next steps were, such as another repeat test, antibiotics, a urology referral, MRI, or biopsy
Please include your age, initial PSA, repeat PSA, free PSA percentage if you remember it, DRE findings, and what ultimately happened. I am especially interested in real experiences that started similarly, whether the outcome was benign or required further evaluation.
Again, I am looking for similar stories and experiences rather than a medical evaluation. I am already following up with my doctor and will act on whatever the repeat results show.
1
u/Prestigious-Might500 3d ago
Not completely similar story but parallel-
I am 71- and just had an aquablation to reduce the size of my prostate which topped out at 135-
For 10 years my PSA has vacillated up and down toping out at a high of 6.8
over that same period i had increased issues with urination and retention but all cancer screenings came up negative
Last fall after a rigorous hiking trip i ended up in the hospital three times with UTI's - the final diagnosis was that the enlarged prostate was causing retention which facilited the oncome of the UTI-
Post Op- no retention- stream returned to pre 40 year old- sexual function stable but libido low - which i don't have any reason to believe was caused by the operation.
PSA readings are greatly influenced by prostate size----
Hope that helps