PSA still result of Prostatitis or PC?

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Age 47: On 1/7/18 my psa was 109 (yes 109!) and i was diagnosed with a uti and acute prostatitis. I have been on cipro for 3 months now starting with 1000 mg day, to now taking 250 ml. I have had 4 more pass since and all have been lower: 10.1, 7.6, 5.5, 5.3. My last two readings were done 5 weeks apart, with not much difference. I am worried now that this probably means PC. I have a follow up with my Uro. in 1 month. Any thoughts? Could it still be related to prostatitis since numbers are going down ever so slightly now, even though it's been 3 months?

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12 Replies

  • Posted

    Prostatitis can take a month to years to clear up. Consider a 3tMri to take a peek. Odds are low its PCa.
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  • Posted

    Dennis,

    The PSA goes up when the prostate is irritated and I'd say your prostatitis is a prime candidate for the irritation. Once that's cleared then I would ask for imaging, and, depending on what that shows, the next step would be a biopsy - unlikely you would need one if the MRI doesn't show anything suspicious. 

    Tom

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  • Posted

    I am surprised your Uro did a PSA test with a known or suspected infection. All 5 Uros I went to through my ordeal have all said you cannot get a valid PSA during a bout or suspected bout of infection.

    That's about all they have agreed on LOL!

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  • Posted

    Just a quiet word of warning: three months of Cipro is a helluva lot of Cipro.  It might be wise to see about another antibiotic if your docs think you need to take any more.  Trimethoprim (Bactrim) is also recommended for prostate problems but is much safer than Cipro.  (Cipro's toxic effects accumulate in the body and eventually cause fluoroquinolone toxicity - see the discussions on this thread about it).

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    • Posted

      Yes - good idea!

      For those who don't know, this warning letter was from Bayer to all doctors to explain the revisions to the Black Box Warnings.  It says the warnings

      "...have been revised to include information regarding the risk of disabling and potentially irreversible serious adverse reactions..."

       

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    • Posted

      The latest BNF still has them listed for prostate and urinary infections. I had looked again as this months mentioned updated information but it still says :

      Prostatitis can be difficult to cure and requires treatment for several weeks with an antibacterial which penetrates prostatic tissue such as some of the quinolones (ciprofloxacin or ofloxacin), or alternatively, trimethoprim.

      Suggested duration of treatment is 28 days.Where infection is localised and associated with an indwelling catheter, a bladder instillation is often effective.

      Uncomplicated lower urinary-tract infections often respond to trimethoprim or nitrofurantoin, or alternatively, amoxicillin, ampicillin or oral cephalosporin. 

      Suggested duration of treatment is 7 days, but a short course (e.g. 3 days) is usually adequate for uncomplicated urinary-tract infections in women. 

      Infections caused by fully sensitive bacteria respond to amoxicillin.

      Widespread bacterial resistance to ampicillin, amoxicillin, and trimethoprim has been reported. Alternatives for resistant organisms include co-amoxiclav (amoxicillin with clavulanic acid), an oral cephalosporin, nitrofurantoin, pivmecillinam hydrochloride, or a quinolone. 

      Fosfomycin can be used, on the advice of a microbiologist, for the treatment of acute uncomplicated lower urinary-tract infections caused by organisms sensitive to fosfomycin. 

      Long-term low dose therapy may be required in selected patients to prevent recurrence of infection; indications include frequent relapses and significant kidney damage. Trimethoprim, nitrofurantoin and cefalexin have been recommended for long-term therapy. 

      Methenamine hippurate (hexamine hippurate) should not generally be used because it requires an acidic urine for its antimicrobial activity and it is ineffective for upper urinary-tract infections; it may, however, have a role in the prophylaxis and treatment of chronic or recurrent uncomplicated lower urinary-tract infections.

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  • Posted

    In 2013 I had taken 7 days of Cirpo for an insect bite - 4 months after completing the course I completely ruptured my Achilles Tendon (AT). I am sure it was related to the cipro as I am a marathon runner, former collegiate athlete and always in excellent health and have never had any kind of tendon troubles before.

    For this current bacterial prostate infection (mycoplasma hominis definite/possible ureaplasma ureactulym) I weighed the risks and decided to take the fluoroquinolone due to the ability of the prostate to readily absorb them. Also, I was (at that time) unaware that prostate fluid should be cultured first to see what bacteria are present and what antibiotics they are susceptible to. 

    I took the following fluoroquinolone in this order 10 days Levofloxacin (definite pain and soreness in old AT rupture site but definite improvement for prostatitis symptoms). I was 'cured' but after 20-25 days I had a relapse of prostatitis. So then followed this course by 25 days Cipro (less pain and soreness in old AT rupture site but still noticeable) with improvement to symptoms but the infection remained and so then (at my request) upgraded to 10 days Moxifloxacin (even less pain and soreness in old AT rupture site but still noticeable and then my shoulder tendons started to feel 'funny'wink - again the infection was not killed. 

    Finally, I started a course of minocycline based on a culture of prostate fluid and so far that seems to be working much better. I have stopped all fluoroquinolone - why Urologists don't do a prostate fluid culture FIRST is beyond me. 

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  • Posted

    There are some great responses here. I would first consider a semen sample to narrow down bacteria.  There is a company that specializes in this.I cannot name the company, the website will moderate. Message me.

    I am active and had similar problems with cipro. I developed planters fasciitis in both feet, tendonitis in both shoulders. It took about one year to recover from the damage caused by cipro.

     

     

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    • Posted

      To both you and AC 10965

      Once you have been affected by a fluoroquinolone you should make absolutely sure you never take another one - ever again! 

      KT - you were lucky that you felt recovered after one year, some people are still in complete agony many, many years later. If you take another FQ the adverse reactions can come back with a vengeance.

      Ac  - you've almost had the whole lot and it's interesting to read that your symptoms were slightly different with each one.  At the end of the day, they all do the same job - they cause oxidative stress damage in all your cells plus they damage your mitochondrial DNA (the mitochondria provide the energy for each cell - i.e. YOUR energy) which may not recover 100% so you are left with reduced capacity.  A further course may well cause further damage and the mitochondria won't recover - causing permanent issues.

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  • Posted

    Dennis, hopefully it's not cancer.  Prostatitis, will elevate your psa, so maybe that's why your number is high.  My urologist, told me a few years ago, that most prostate cancer's would take an average of 13 years from the time you have it till it does you in.

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