Are high PSA levels and occasional frequent urination suggestive of kidney infection?

Question

Hello doctor,

I am a 31-year-old male with a normal BMI, and no other known health issues, non-smoker, non-drinker, and no drug use ever. My appendix got removed 10 years ago. I have been experiencing high PSA and occasional frequent urination for one year now. The latest total PSA is 9.95. Urine or semen culture is always negative for bacteria so I decided to wait for EPS before taking Ciprofloxacin. I have taken fosfomycin empirically for two weeks last month, symptoms subsided but came back a few days after Abx termination. Lately, feeling a bit under the weather, I do not have but definitely feeling weak and malaise-like. Some flank right-side discomfort is also present. So I decided to do some tests. My concerns and questions are:

1. Is this kidney infection from the lower urinary tract?

2. Why were hyaline cast and renal tubular epithelial cells found?

Seems high amounts, especially RTECS. Very concerned since RTECS with a hyalin cast can suggest something.

3. What do you suggest I should do next? Please suggest further tests and medication. I also read if left untreated, long-term kidney scarring can happen. Hoping it is just an infection that Abx can handle and not something else like acute tubular necrosis. Pleae help.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern. Primarily it seems to be an infection and do not worry about casts presently. Your PSA (prostate-specific antigen) levels are high which might be due to prostatitis. It needs minimal four weeks of antibiotics (Ciprofloxacin and Metronidazole). You are positive for gardenella vaginosis (due to unprotected sexual intercourse recently). Repeat PSA levels after two months by taking antibiotics treatment for one month.

I hope this helps you.

Regards