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Burning and increased PSA after radical prostatectomy

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Alan J. Wein, MD
Last Modified: January 1, 2002

Dear OncoLink "Ask The Experts,"
My father had radical surgery done for his prostate cancer. Post the surgery, his PSA levels again went up albeit, to 8. Since then however, my father is having a burning sensation when he urinates. Is this normal? What can be causing it? He describes the pain as intense at times.  

Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:

Following prostatic removal for cancer, the PSA should drop to immeasurable levels and stay there. If your dad's PSA is now 8, this unfortunately signifies that he has recurrent or residual disease. He needs to see his urologist. Here at our institution, we would institute adjunctive treatment. Regarding the burning sensation, this could be due to urinary tract infection or irritation. This is certainly of secondary importance to the issue of the measurable PSA. However, a urine culture should certainly be obtained and any infection that is found should be treated. If he does not have an infection, then there are a number of conditions that can contribute to burning on urination and your local urologist is the individual best equipped to find and treat these. It is doubtful that the burning means anything of a serious nature.