By Dr. Casey McCullough, Advanced Urology

Prostate Anatomy, Physiology, and PSA Elevation

The prostate gland is an important part of the male reproductive system and helps men have children. The prostate is located below the bladder and above the penis. It surrounds the urethra, which is a thin pipe that acts as a passage for urine from the bladder to outside the body. PSA is released by the prostate and can be elevated because of inflammation, infection, benign enlargement, or prostate cancer.

The prostate is known for secreting prostate fluid, an important part of semen. When a man ejaculates, sperms migrate from the testicles to an area along the prostate. The prostate pushes the prostate fluid into the urethra where it mixes with sperm and both leave the body as semen. About one-third of the semen excreted semen is made up of prostate fluid.

The male prostate begins to naturally expand after the age of 40. This condition is known as benign prostatic hyperplasia (BPH). Prostate enlargement occurs because of aging, genetics, and testosterone that is released by the testicles. This enlargement causes PSA elevation.

The prostate gland is walnut-sized and shaped. In the early development stages of prostate enlargement, the muscles of the bladder thicken and disturb the urinary flow. The urine will have to pass through a smaller diameter, therefore the urethra will have to contract significantly. This causes the bladder muscles to be more sensitive, resulting in the need to pass urine frequently.

The increased growth in the prostate gland presses the urethra with more force. This blocks the flow of urine and creates more frequent urination, slow stream, and incomplete emptying..

Sometimes, prostate enlargement may cause urine to back up, resulting in recurrent urinary tract infections, bladder stones, and possible kidney damage. As the prostate grows, it will naturally produce more PSA (prostate specific antigen), which can circulate in the blood stream and be one of the causes of an elevated PSA value.

PSA elevation can also be from infection. We have high tech molecular PCR testing to determine if an infection is present.

Inflammation from diarrhea, the common cold, virus, or other systemic inflammatory processes can also cause PSA elevation. In this case, re checking the PSA once the inflammatory event passes is a great idea.

The last cause of elevated PSA is prostate cancer. Prostate cancer has no symptoms early in the disease process. Even men with aggressive prostate cancer have very few symptoms. The best step is to perform a high resolution micro ultrasound prostate biopsy. This technology is exclusive to Advanced Urology in Georgia. The biopsy is typically done in about fifteen minutes in our state of the art surgery centers with anesthesia.

We can best determine whether your PSA elevation is caused by either growth of the prostate gland (benign or non cancerous), infection, inflammation, or by prostate cancer. Call today to schedule an appointment!