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Prostate Health Specialist

Total Urology Care of New York

Urology & Uro-Gynecology

At Total Urology Care of New York, we provide urology services to patients in Manhattan and the surrounding areas. We help patients with their prostate health, including elevated PSA and enlarged prostate.

Prostate Health


Below you will find answers to our most commonly asked questions. If you don't find the answer you are looking for please contact us at (212) 218-3900

What Is a high PSA level?

PSA varies based on prostate size and age. However, a “normal” PSA should fall under 4.0 ng/dl. Our understanding of PSA has been changing. Each individual situation has to be evaluated to be able to put the value to use.

How is a PSA screening test performed?

The PSA screening test usually requires that the patient give a blood sample. The blood is then sent to a lab where it will be examined and results are usually returned within a few days. The patient consultation will involve an evaluation of the PSA level taken in the context of the patient’s previous PSA levels, and whether or not there are signs of an infection or inflammation of the prostate as the presence of these can cause a benign elevation of the PSA. In addition, a digital rectal examination will be performed during the office examination to feel for any hard to suspicious area in the prostate that may suggest the presence of a tumor. It is also important to factor in possible prostate cancer risks a patient may have when interpreting PSA results such as a family history of prostate cancer.

Does an elevated PSA mean I have cancer?

In some cases, patients who have prostate cancer have high PSA levels, so health professionals often use blood PSA measurement as a cancer screening. However, this level does not always indicate cancer. Men with prostate cancer can have PSA levels lower than 4.0 ng/dl. In addition, plenty of men have had elevated PSA numbers and do not have prostate cancer. A higher PSA level is a risk factor for cancer but does not determine cancer on its own. Instead, other risk factors are involved. Instead of cancer, a high PSA level could mean you have inflammation in your prostate gland or an enlarged prostate. Checking the PSA level on a regular basis can also be helpful in managing low-risk prostate cancer, which does not necessarily need treatment.

What if I have already had prostate cancer?

Your urologist will check your PSA level on a regular basis if you have previously had prostate cancer and went through treatment. In this case, a higher level might show that cancer has come back. Your doctor would give you more tests to be certain about a recurrence of prostate cancer.


What is an enlarged prostate?

As men age, their prostates enlarge. As it enlarges, it can cause tension on the urethra, the tube through which urine passes from the bladder out of the body. The tension can lead to symptoms of obstruction, such as slow flow, difficulty starting the stream, and incomplete emptying. These symptoms can often be alleviated by medications. Minimally invasive procedures and hospital-based procedures are available as well. The process of enlargement is benign in that it does not indicate that cancer is present. Most symptoms that are related to an enlarged prostate come from benign prostate growth.

What are causes and symptoms?

The symptoms of an enlarged prostate include difficulty with starting the flow of urine, slow flow, intermittent flow, incomplete emptying, and dribbling after urinating. Health professionals do not fully know what causes BPH (Benign Prostatic Hyperplasia). It may be hormonal as the active levels of testosterone reduce with age which may be a factor. The actual function of the prostate is not clear. Behind the prostate are two glands called the seminal vesicles that produce most of the fluid found in semen.

What are treatments?

Not every man needs treatment for benign prostatic hyperplasia – it depends on how severe his symptoms are. Treatment for BPH is set by the severity of the symptoms and whether the bladder is deteriorating as a result of the prostate size. If you do need treatment, it could vary based on your specific symptoms and prostatic anatomy. Life style changes and medication solve many patients’ symptoms. Sometimes, a minimally invasive procedure or surgery will be necessary.


  • Accepted Insurances

    Please contact us to see if we accept your insurance provider.

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    And all major commercial insurers providing out of network benefits.

    Need-Based Care

    Dr. Kavaler provides need-based care for patients without private insurance or the ability to self-pay. If you have a marketplace plan, Medicaid, or neither, Dr. Kavaler provides her specialized care at Lincoln Community Hospital, in the Bronx regardless of your ability to pay.

    Contact Lincoln Community Hospital for the urology clinic's schedule.

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