What is the role of routine prostate-specific antigen (PSA) testing in the workup of chronic bacterial prostatitis (CBP)?

Updated: May 25, 2021
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Routine PSA testing during a prostatitis episode is not recommended. Most patients with clinically proven bacterial prostatitis have an elevated PSA value independent of any cancer-related elevation. No prostatitis-adjusted tables are available to indicate which PSA values are inappropriate in this patient population.

In patients with bacterial prostatitis who have an elevated PSA value, a reevaluation of the PSA value 6-8 weeks after appropriate treatment is recommended to ensure the value is decreasing to normal levels. It is also appropriate to review the patient’s recent PSA values as a point of comparison. If values remain elevated after appropriate therapy, prostate biopsy is recommended to rule out concomitant pathology.

PSA testing should be considered to exclude prostate cancer only if the findings on digital rectal examination (DRE) raise concern. If PSA testing is done, it should be postponed as  follows:

  • After DRE - 1 week
  • After treatment for a UTI -  6 weeks
  • After prostate biopsy - 6 weeks
  • After vigorous exercise or sexual intercourse - 48 hours

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