Rising PSA After Infection

Hi new here.
Have been reading for a few months and appreciate the sharing of experience and insights.

I am 59 y/o and have had a baseline PSA of approx. 1.4 for past 5 years. In June i got a UTI and my PCP (Dr.) treated with Levoflaxicin 750mg for 5 days that cleared the infection and symptoms but he added 500mg for 7 additional days to be sure.

In any case i had a PSA jump to 4.7 in Aug and then 5.2 in early Sept. He put me back on 500mg Levo for 28 days to see if that would lower. Well, my subsequent PSA level on 10/20 was 5.5.

He has now referred me to a Urologist, but couldn't get an appointment until 11/29. My main question is could this still be attributable to the infection i got in June? Would PSA level remain elevated that long? Also, for future PSA tests, should i request Free PSA also, haven't had that test as part of my labs to date. I am a little worried, as the PSA level has continued to rise with antibiotics, when expectation was to return to baseline.

Thanks for any insight or thoughts.

Around a dozen years ago I had extreme prostatitis, characterized by a fever and inability to urinate. Was admitted to hospital where I received intravenous antibiotics and catheterized for around 2 weeks. Was released after around 4-5 days. My PSA level during this event was in the 30's, maybe as high as 36 or 8. Within a few months it was in the 5-6 range. As I remember, it took 12-18 months to get back to my usual .9-1.5 range. My uro during that first month wanted to do a biopsy, but that didn't make any sense because the greatest indicator for a high PSA was from the infection. I proved to be right. With PSA you always have to eliminate anything else that may be elevating that number.

Post Edited (GaryDouglas) : 10/27/2017 1:59:10 PM (GMT-6)

Hey guys,
Update from last post. Had Urologist appointment on 11/29. They did UA and PSA test that included Free PSA which i havent had yet. Uro indicated this was a more sensitive test than what i have had in past. Also DRE. After DRE he said wanted to do an Ultrasound next. So i got that scheduled for 12/19. I just got PSA test results from labs. It appears some good news my total PSA was 4.8 down slightly. Free = .58 with ratio 12. I am not sure what to make of that number. Any thoughts or insight there appreciated.

Will post after Ultrasound.

Thanks for the response and the link with info...I appreciate it.

I suppose my best case scenario would have been a free ratio over 25% !!
I am curious if the 12% would justify biopsy? At this stage I have the urinary difficulties, elevated PSA (albeit - only slightly over the 4 threshold) and the free ratio at 12%. I am thinking auto will recommend, but I guess I will just have to wait and see. Appointment is 12/19.

Thanks

Update.

Well, I had an ultrasound test yesterday at Urologist. Dr indicated that no glaring problems but there was a dark band in lower section of prostate. He said could be a little inflammation or even cancer but he cant tell more from this test. He left it up to me to make a decision on next step. Said he didnt want to unduly inflluence me toward biopsy. I said i would prefer to know if i have cancer or not! After i made the decision for biopsy, he said i made the right decision. That exchange was a little unsettling as i looked to him to advise me of next steps based on information at hand.

Recap of my recent situation.
- age 59 (60 in April)
- baseline PSA 1.4 over past 4 years
- on TRT 3.5 years
- urinary infection June treated successfully and clear on UA after 10 days)
- Aug PSA 4.7; Sept PSA 5.2; Oct PSA 5.5
- Nov Total PSA = 4.84 and Free PSA .58 or 12% Ratio.
- Dec Ultrasound slight dark band but nothing glaringly obvious. Size of prostate appears normal for my age.

Curious if this warrants biopsy or if waiting and continued PSA testing is appropriate next step.

Appreciate you all sharing your experience and insight. Thank you.