When is biopsy recommended for raised PSA?

PSA can rise for reasons other than prostate cancer, including benign prostate enlargement, inflammation, infection, recent ejaculation or urinary procedures. One result is therefore interpreted alongside your age, symptoms, medical history and the pattern over time. A clinician may repeat the blood test after addressing a possible temporary cause, then discuss a rectal examination or magnetic resonance imaging. Imaging can help identify an area that needs closer assessment, but it cannot by itself provide a tissue diagnosis.

Arrange a review with a urologist or the clinician who requested the PSA test. Ask whether the test should be repeated and whether infection, medicines or a recent urinary procedure could have affected it. If biopsy is advised, the clinician will explain whether samples are taken through the skin or through the rectum, how infection prevention is managed, and what preparation is needed. The samples are examined by a laboratory, and the result is discussed with you rather than interpreted from the PSA alone.

Contact a clinician promptly for difficulty passing urine, inability to urinate, fever with urinary symptoms, blood in the urine, or severe pelvic pain. After a biopsy, seek urgent medical advice for fever, chills, heavy bleeding, worsening pain or trouble urinating, because these can signal a complication requiring assessment.

What could have raised my PSA, and should it be repeated? Do I need an examination or prostate MRI before deciding? Which biopsy approach do you recommend, and how should I prepare? When and how will I receive the pathology result?