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Can Likely Scar Tissue from a Bike Riding Accident Cause High PSA, 8.5
Can Scar Tissue from a Bike Riding Accident Cause Permeant High PSA Level of 8.5?
Thank you for this prostate forum. I am 65-years old and just recently went to a urologist for the first time, after I sought hormone replacement therapy HRT approx. 1.5 years ago, wherein my PSA level at that time was 8.50, and remains as such never significantly reducing or climbing.
An MRI with contrast was performed, wherein a 10mm x 11mm benign lesion was detected in the posterolateral perennial zone. Note that I have absolutely no symptoms of BPH, Prostatitis, UTI’s, no swollen reginal lymph nodes, no history of cancer of any kind in my family, etc.
However, I believe that more than likely I injured my prostate approx. 20 years ago in a violent mountain bike crash, the impact was so hard that the forks on my bike were bent and cracked at the welds. Unfortunately, my prostate also took all the blunt force from the bike seat and bike top tube impact. I believe that my left pubis bone was also cracked as the pain has never gone away. Also note, I am an avid mountain bike rider with an estimated 15,000 miles, all on mountain trails.
For several week afterwards, I was ejaculating bright red blood very heavily. However, the blood was only in the semen and never in the urine, indicating an apparent prostate injury and ensuing scar, this being described as a benign lesion.
Another important note, as a direct result of this injury, my semen volume immediately began to drop, and within a month or so later the volume was approx. 60% less, and has continued to drop to this day. I estimate the semen volume in now at approx. 80% less than from before the injury, and of course I’m 20 years older now.
Question: Can a PSA level sometimes known for some men to be between 4-10 PSA, with no signs of cancer or disease, and my PSA is an average of 8.5 PSA with no symptoms, can this be caused by the likely scar, or benign lesion as described, and, can this also be the cause of my drastically diminished semen volume?
Thank you kindly for any input provided!
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Sounds like you’ve recovered from that bike accident. What was the PIRADS rating on that lesion? Did you have a biopsy that showed it was benign because the PIRADS score was very low?
Damage to the prostate that causes scar tissue can cause the PSA to be high for a very long time.
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2 ReactionsThank you Jeff,
PIRADS-4, this was based on 13.4 PSA and the lesion size. However, the test seemed too high based on my previous tests, and for some reason they did two blood draws claiming that the first test was tainted??? Sooo, five days later I independently tested three PSA blood tests, all within 1.5 hours, and the average PSA was 8.5.... wtf?
The doctor couldn't really answer the 5 point difference, nor answer the trauma possibly causing the blood, the diminished semen volume, the lesion possibly being permeant scarring, and that my 8.5 average PSA's are my norm based on the injury.
I've learned that physical trauma to the prostate can lead to scarring and sometimes long lasting increase in PSA levels!
Finally, no biopsy yet as I'm wanting to understand if I even need one, or active surveillance as I have no symptoms and the testing has only been since December 2025.... three months. 👍
@rapco101 PIRADS 4 is usually suspicious for cancer…perhaps a PSE test would be more definitive before going thru a biopsy as it is 94% accurate for the presence of PCa.
Your bike accident sounds horrible - and certainly could have caused lasting damage to the prostate; many older injuries show up on scans and are discounted for that reason.
Phil
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2 Reactions@rapco101
PIRADS-4 calls for a biopsy. The PSA is not relevant with that higher risk result.
As @heavyphil Recommends, a PSE test could resolve this without a biopsy. I think he knows I would’ve said the same thing. I’m saying it again because you really need to be aware this is an issue. You need to be proactive.
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2 ReactionsThank you Phil,
First, I am learning that these tests including MRI's, PSA's, PIRADS scores, biopsy's, etc.... are all subjective to the professional's opinion and riddled with false-positive results up to 50%-75% in some cases.
I questioned the doctor as to whether the PIRADS-4 could be reduced to a PIRADS-3, the doctor said 'maybe'.... once again subjective and not definitive.
And, a biopsy certainly has its risks including infection and time to heal from the procedure. My 72 year-old buddy blead for two months, and never recovered from erectile disfunction. These are issues that I am trying to avoid.
Info from Internet AI:
"The PSA test for prostate cancer has a high false-positive rate, commonly cited between 15% and 75% depending on the study and threshold used. Real-world data indicates that up to 46.6% to 50% of elevated PSA results are false positives. Only about 1 in 4 abnormal results (25%) indicates actual cancer, often leading to unnecessary, invasive biopsies and patient anxiety."
Sadly, the doctor seems incensed on only getting me to commit to a biopsy, he seems to have no regard nor opinion of the likely traumatic injury to my prostate, the excessive heavy bleeding in my semen, the likely scaring which could be misdiagnosed as a cancerous lesion even that it is benign at this time, the reduced semen volume, the higher PSA levels, etc...
My doctor has failed to answer many off my questions..... thus, I'm seeking other opinions including those from doctors.
Best regards,
Ricardo 😊
@jeffmarc
Jeff,
Yes, I agree and I do have a PSE test from ExoDx, to be taken today and sent overnight.... I'll post the results.
I greatly appreciate the recommendations from the guys here that have gone through this madness! 😊
BTW, I don't think that the PIRADS-4 was accurate.... please see my response to Phil.
Best regards,
Ricardo 👍
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1 Reaction@rapco101 Absolutely! Second - and third - opinions are a MUST.
However, what you are reading about rectal biopsies is old news - newer trans-PERINEAL biopsies avoid most of these issues as they are extremely focused (on the PIRAD lesion), well targeted using both MRI and sonogram and do NOT go thru the rectum causing bleeding and infection.
Find yourself a urologist who does ONLY transperineal biopsies and you will be fine!
Phil
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1 Reaction@heavyphil
Thank you Phil,
Yes, I am aware of transperineal biopsies and have already requested it, despite that when we first met in December 2025, the doctor only suggested the transrectal biopsy. In this procedure, he said that my prostate would require 12-16 core samples.... wtf! Yes, the transperineal is much better option and the clinic does offer it.
Personally, I would like to take an 'active surveillance' approach, maybe 6 months to see if anything changes occur, lesion size, PSA, etc. If this is an injury, I believe there should be no changes.... and hopefully no cancer!
BTW, the PSE test was taken yesterday, overnighted to the lab.
Gratefully,
Ricardo
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