Mens Health

Question 1

What are the age thresholds for doing a PSA on an ASYMPTOMATIC male

Answer 1

40-70yrs with FHX
50-70yrs with no FHX

<45yr is very rare
>70 is appropriate if FHX or life expectency of >10yrs

Question 2

What symptoms should make you consider a PSA test

Answer 2

Men 40-70 with FH
Nocturia, frequency, delay, post-urination dribble, poor stream, haematuria, sensation of incomplete emptying
Erectile dysfunction
Red flags which are suggestive of metastatic prostate cancer include:2, 4

Bone pain
Macroscopic haematuria
Acute neurological symptoms consistent with spinal cord compression or cauda equina syndrome
Renal failure
Elevated blood alkaline phosphatase levels

Question 3

red flags for haematospermia

Answer 3

patient’s age (>40 years)
recurrent or persistent haematospermia
prostate cancer risk factors (eg positive family history or African heritage)
constitutional symptoms (eg weight loss, anorexia, bone pain)

do PSA + DRE + REFER