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PSA or Prostate Specific Antigen, is a protein that is produced mainly by the cells in the Prostate. The prostate is a small gland in men that surrounds the urethra and produces a fluid that makes up part of semen. Most of the PSA that is produced by the Prostate Gland is released into the fluid but some of it enter the blood stream. The IHC (immunohistochemistry) test is conducted to find the amount of PSA in the blood. The PSA test helps to monitor and screen prostate cancer in men.

For the test, there are certain things you need to take care of. You should avoid ejaculation at least 24 hours prior to the sample collection as ejaculation often leads to an increased PSA level. Also, the sample should be collected before your doctor performs the Digital Rectal Exam and Prostate biopsy. These can also elevate the levels of PSA.

The test results are usually available in a few days’ time. If the value of PSA is less the 4.0 nanograms per millilitre of blood, it is unlikely that you have prostate cancer. If the value of PSA is between 4.0 and 10.0 nanograms per millilitre of blood, then it may mean that you have prostate cancer or you have inflammation of the prostate. If the value of PSA is above 10.0 nanograms per millilitre of blood, you may have an increased risk of having prostate cancer.

For the test, your doctor or lab technician will place a plastic band on your upper arm; this is done to fill up the vein with blood and swell up. Then, he or she will clean the area with an antiseptic and put a needle. He will then draw a blood and keep it in a vial or tube. The plastic band and needle are removed and a bandage is applied to the area to stop the bleeding. The whole process usually takes a few minutes. The collected blood is then sent to the lab for analysis.

Type Gender Age-Group Value
Total PSA
< 40 years
< 2 ng/ml
Free PSA: Total PSA Ratio
All age groups
When the Total PSA is 4-10 ng/ml, a ratio of < 0.10 indicates a 49-65% risk of prostate cancer
Average price range of the test is between Rs.465 to Rs.1400 depending on the factors of city, quality and availablity.

Table of Content

What is IHC, PSA Test?
Preparation for IHC, PSA Test
Uses of IHC, PSA Test
Procedure for IHC, PSA Test
Normal values for IHC, PSA Test
Price for IHC, PSA Test
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Popular Questions & Answers

I am 65 years old have prostrate problem Dr. prescribed lifelong pill still advise alternative.

MBBS, MS- General Surgery
General Surgeon, Ambala
I am 65 years old have prostrate problem Dr. prescribed lifelong pill still advise alternative.
Please, get the following investigations- 1) Ultrasound of prostate including post void urine volume. 2) PSA 3) Urine exam. Treatment depends on your symptoms and these reports. Mild problem can be managed with medicines. If you are having very much increased frequency of urination, and specially at night, then the definite treatment is endoscopic surgery (TURP)

I have recently done a blood test and it shows tha t my PSA level is 5.130.Does this mean I have cancer. Two years back I have done the same test it had shown 4.36 and mg doctor had recommended me a biopsy which I had gone through and the result was negative. But why has my PSA level risen so much. My age is 54 .please help me out.

FACS, MBBS, MS - General Surgery
Oncologist, Gurgaon
Yes dear, your P .S. A level is in Rising scale. Normal level is less than four. But one can't diagnose Cancer prostate only on the basis of p.s.a level, so to confirm you must undergo for M.R.I lower abdomen and pelvis and repeat biopsy. Let me tell you I had treated same case in stage one to two with an alternative one drug therapy while working abroad and he is disease free. If you feel contact me through Lybrate with appointment.
9 people found this helpful

I suffer from enlarged prostate. For many years I am taking medication. But I don't think I am getting better. Any remedy without surgery. I am 77. Taking Dutas and Urimax. Frequent urination in the nights.

Sexologist, Mumbai
I suffer from enlarged prostate. For many years I am taking medication. But I don't think I am getting better. Any re...
Avoid drinking water 4 hrs before sleep. Do kegel exercises. Ie contraction n relaxation of anal muscles, atleast twice a day, 25 times at once. Masturbate once a week atleast. It will definitely prevent you from surgery. Don't worry about PSA TEST and its values.
2 people found this helpful

I have already undergone prostrate gland operation in 2006. Recent USG shows prostratomelagy. Please let me know the remedy to this problem. Twice or thrice there were clots of blood in the urine, but it has stopped now.

MS - General Surgery
General Surgeon, Kanpur
I have already undergone prostrate gland operation in 2006. Recent USG shows prostratomelagy. Please let me know the ...
if you have symptoms of prostate then start medicine like tab dutalfa 1 od otherwise don't, get serum PSA done, sometimes repeated surgery is needed.
1 person found this helpful

Popular Health Tips

Prostate Cancer and Its Psychological Impact

DNB (Urology), MS - General Surgery, MBBS
Urologist, Delhi
Prostate Cancer and Its Psychological Impact

Prostate cancer is a very painful disease to go through. However, what some people do not realize is that prostate cancer is equally disturbing from a psychological viewpoint, both for the patient and the family.

Here are some psychological impacts of prostate cancer:

  1. Shock, fear or anger: These are immediate reactions and you could feel any or all of these feelings when the disease is first reported to you. These feelings may continue for some time, but if the patient is unable to come out of the state of the anger for a long time, then he may need psychological help.
  2. Denial: Sometimes, you may feel well and deny the fact that you have prostate cancer or not realize you really do. Accept it! This is the first step to curing it.
  3. Frustration and disappointment: Try to avoid these types of feelings and if you do, then go to a shrink as well, as these are signs of depression.
  4. Stress: This is also a natural feeling and will haunt you till this disease is gone. However, there are many ways to help reduce it.
  5. Worrying: This is usually related to the side effects in the early stages of prostate cancer. Trust your doctor. Finding a support group or talking to people in similar conditions may help.
  6. Mood swings: This is one of the side effects of the hormone therapy used to treat prostate cancer. It may cause you to get angry and anxious and then tearful and depressed.
  7. Anxiety: Some men are overly worried about their prostate-specific antigen or PSA test results. The anxiety may continue even after the PSA test is over.
  8. Sense of loss: Hormone therapy causes many physical changes in your body, including weight gain, changes in your sex life as well as reduced physical strength. Few things will be the same after prostate cancer in all honesty. Talking to the people around you can help more than you know.

While prostate cancer can cause all sorts of negative emotions, it is crucial that you use your family to stay strong and do not slip into depression. There are also a few patients, who accept this diagnosis well, if properly counselled. In the majority of cases, prostate cancer grows slowly. In those cases, new drugs are available which help the patient lead a near normal life.

4674 people found this helpful

Effects Of Frequent Sex On Vagina

MS, MBBS, MICOG, Diploma In Laparoscopy
Gynaecologist, Delhi
Effects Of Frequent Sex On Vagina

The vagina is a muscular, tubular structure of the female genital tract extending from the vulva to the cervix (the opening of the urethra). Sexual activity affects vaginal health in a number of different ways during intercourse and in the long term.

How Does Sex Affect Your Vagina?

These are some effects on regular sex on your vagina, such as a change in size, Vaginal secretion, Unusual discharge, Infections in the urinary tract, and pain in the vagina:

  1. Changing the size of the vagina: The vagina is designed to be elastic and adjustable. So, no permanent change in size is possible but it does undergo temporary changes in sizes as effects of sex. The inner walls of the vagina enlarge during sexual intercourse and during childbirth. Tissues in the clitoris puff out and harden, this also causes an expansion in size. It takes a while to get back to its normal size.
  2. Vaginal Secretion: When you are aroused during sex, the blood vessels supplying the vagina expand immediately. The blood flow increases to lubricate the vaginal walls (rugae). The rugae unfold and space increases. These secretions are important because, women who are sexually inactive for a long time at a stretch, experience dryness that leads to urinating difficulties and rashes.
  3. Unusual Discharge: Apart from natural lubricants, after sex vagina secretes some fluids, the process being termed as 'female ejaculation'. A tiny amount of white fluid made of prostate plasma cells is produced just before you climax and discharged with some quantity of urine. Sometimes, prostatic specific antigen (PSA) and prostatic acid phosphatase (usually found in semen) are also found in the secretion.
  4. Infections in the Urinary Tract in Vagina After Sex: The friction caused by sexual intercourse may cause small cuts that enable bacteria to pass from the vagina to the urinary bladder through the urethra. This causes infection in the bladder, the urinary tract, and the vagina. These can be avoided by using a condom or by urinating before and after having sex.
  5. Vaginal pain: A lot of women report the experience of pain and discomfort inside or around the vagina during and immediately after sex. The pain can result from repeated sex within a short period of time or reduced secretion of natural lubricants. If the pain is too severe, you should see a doctor because yeast infections or chronic vulvodynia can also be responsible for the pain sensation.

Update From Lybrate: Due to stress and hectic lifestyle, sexual bliss has become a dream for many. Buy these Sexual Wellness Products from Lybrate's GoodKart. To keep your sex life alive and kicking.

In case you have a concern or query regarding gynaecological issues, you can consult a gynaecologist online & get the answers to your questions through .


3910 people found this helpful

MD, sexologist, Fellowship
Sexologist, Srinagar

Serum PSA and Testosterone Levels

Serum PSA levels may useful for diagnosing hypogonadism (low testosterone), Italian researchers say.
In the past, the relationship between PSA levels and testosterone has been difficult to define, as some researchers have found a connection and others have not.

The goals of this study were to better understand this possible relationship for men with sexual dysfunction and to determine whether PSA levels may give information about testosterone levels.

Almost three thousand men participated in the study. All of them were seeking treatment for sexual dysfunction and had PSA levels of less than 4 ng/mL. They ranged in age from 18 to 85 with a mean age of 52.5 ± 12.4 years.

A variety of physical measurements were conducted, including blood pressure, waist circumference, testis volume, total testosterone, HDL cholesterol, and triglycerides. Also, each man was interviewed using the Structured Interview on Erectile Dysfunction (SIEDY), ANDROTEST, a tool that screens for hypogonadism in men with erectile dysfunction, and PsychoANDROTEST, which examines the psychological signs and symptoms of low testosterone.

After adjusting for age, the researchers found that low PSA levels were associated with delayed puberty and lower testis volume, two markers of hypogonadism. Low PSA was also associated with metabolic syndrome, type 2 diabetes, and cardiovascular diseases.
Two other aspects of the research were noted.

First, the authors reported that the “saturation hypothesis” was supported. The connection between PSA levels and testosterone was only present when men’s testosterone levels were lower than average. For men with normal testosterone levels, the relationship was not as clear.
In this study, PSA levels did not rise substantially when total testosterone levels were above 8 nmol/L.

“It might be inferred that [testosterone] therapy in men with values above this point would not be expected to result in a rise in PSA, whereas men with [testosterone] values below this point may very well experience a rise in PSA,” the authors wrote.

Second, age appeared to play a role in the applicability of the findings. Using PSA levels to predict low testosterone was more accurate in younger patients.

“The efficacy of PSA, as a ‘screener’ for hypogonadism is modest and decreases as a function of aging, when PSA levels are affected by other factors, besides androgen activity,” the authors explained.

The study was published online in July in the Journal of Sexual Medicine.

The Journal of Sexual Medicine
Rastrelli, Giulia, MD, et al.
“Serum PSA as a Predictor of Testosterone Deficiency”
(Full-text. First published online: July 16, 2013)
- See more at:
13 people found this helpful

Women: Keep Your Lady Parts Healthy

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Women: Keep Your Lady Parts Healthy (And Happy)

Every part of the body needs care in order for the entire body to work properly. And one of the most intimate parts on a woman?s body, should be no different. See some simple, but effective tips for vaginal health.

1. Wash with warm water only.
Maybe this may sound strange but PSA: your vagina hates soap! A healthy woman?s vagina stays quite clean on its own without the help of harsh chemicals and cleansers. Like many parts of the body, your vagina has a pH level that needs to be maintained. Soap and other cleansers such as douches or feminine sprays not only create an imbalance in your pH often causing the growth of unhealthy bacteria, they rid your lady parts of the good bacteria that helps you fight off infections! So ladies, lets not underestimate the power of H2O.
2. Stay EXTRA clean during your period.
Your chances of getting a vaginal infection increases when you are menstruating due to the blood and pH imbalance that comes because of it. When your time of the month comes make sure you are being even more cautious of your hygiene habits, especially when it comes to how long you are wearing sanitary items. Make sure you are changing your tampons and pads several times a day.
3. Wear cotton underwear.
Cotton underwear dries quickly and allows air to flow freely through the fabric. This prevents the development of damp conditions that promote the growth of yeast and unhealthy bacteria that might lead to an infection. Underwear made from synthetic fabrics, silk, lace or other materials doesn?t breathe as well. F you like wearing underwear made from fabrics other than cotton, make sure the section of the underwear that will be touching your vagina has a cotton liner.
4. Pee after sex.
At the very least, pee after sex, even if you intend on washing, too. When you have sex, unwanted bacteria can travel up the urethra, which is connected to your bladder. Peeing after sex can help flush the bacteria out of the vaginal area, promoting general health and helping you avoid UTIs.
5. Eat lots of fruit.
Cranberries, pineapples, strawberries and other fruits help to freshen the smell of the liquids secreted by the vagina. Eating fruits won?t make your vagina smell like a tropical island, but it can help you develop a more pleasant scent if that?s something you?re concerned about. Fruit also has a high water content, and staying hydrated helps flush the body of toxins that can lead to bad smells.
67 people found this helpful

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Say no to FNAC in prostate cancer

Over 95 percent of malignancies arising in the prostate are adenocarcinoma. The remaining types include urothelial carcinoma, basal cell carcinoma, small cell carcinoma, lymphoma and sarcomas.

Core needle biopsy of the prostate is used to determine whether or not cancer is present in men with an elevated serum PSA level and/or an abnormal digital rectal examination.

The recommendation is to take multiple core biopsies under transrectal ultrasound guidance.

Primary diagnosis of prostate cancer by using fine needle aspiration is not acceptable.

When positive, the combined Gleason score, based upon architectural features of the prostate cancer cells, should be reported because it correlates closely with clinical behavior and has been incorporated into the tumor node metastasis (TNM) prognostic group staging system.

One should also report number of positive cores, the percentage (or length) of cancer in the positive core, the presence of perineural invasion or extraprostatic extension, and the presence of histologic types other than conventional adenocarcinoma.

The accuracy of pathological diagnosis of prostate cancer can be improved by using immunohistochemistry markers.
5 people found this helpful