Assessment and Investigation
Clinic Appointment with the Consultant
You will be seen by Mr Syed who will take a detailed history of your urinary symptoms. He will also ask you about any other medical problems and history of your current medication.
This includes examination of your abdomen, external genitalia and digital rectal examination of your prostate. Abdominal examination will reveal if you are retaining any urine behind in the bladder after voiding. Digital rectal examination is one of the most important assessments for your prostate. A benign enlargement of the prostate is smooth with no area of any hardness, irregularity or nodules which are more common in prostate cancer.
- Prostate Symptom Score and Frequency Volume Chart. You will be asked to fill in International Prostate Symptom Score and Frequency Volume Chart which helps quantify the severity of your symptoms and plan further management.
- Urine dipstick test. Your urine is examined in the clinic to rule out any infection or blood in the urine.
- Blood test. You may require a kidney function test, also called urea electrolytes, to assess your serum creatinine and glomerular filtration rate which are abnormal if there is any kidney impairment.
- Prostate specific antigen (PSA). PSA is a prostate specific antigen which is a protein produced by the prostate gland which helps to liquefy the semen. PSA is produced exclusively by prostate epithelial cells, both in benign prostate enlargement and prostate cancer. A raised PSA level may mean you have prostate cancer. However other conditions which are not cancerous (for example enlargement of the prostate, urinary infection, prostatitis) can also cause higher PSA levels in the blood. If your PSA is raised in the absence of any infection or other benign causes you will require a transrectal ultrasound of your prostate and biopsy which is carried out under local anaesthesia. This tissue is then sent to a pathologist after analyzing samples under the microscope to provide a histology report. Even if the biopsy is positive showing prostate cancer you may be advised one of the following treatments:-