Prostate Flashcards
How long should patients be advised to avoid exercise for, prior to PSA testing?
48 hours
Cut-off IPSS scores?
0-7 mild
8-19 moderate
20-30 severe
Abnormal post-micturition residual?
> 100ml
Management of mild BPH symptoms?
Watchful waiting + lifestyle advice
Management of troublesome BPH symptoms?
Alpha-blocker
If enlarged prostate, offer 5-alpha reductase inhibitor e.g. finasteride
Management options in men with “storage” symptoms?
Offer an antimuscarinic
Exclusion period for PSA testing- vigorous exercise
48 hrs
Exclusion period for PSA testing- proven UTI
1 month
Exclusion period for PSA testing- ejaculation
48 hrs
Exclusion period for PSA testing- prostate biopsy
6 weeks
False-negative rate for psa
15%
False-positive rate for psa
75%
Management of acute bacterial prostatitis?
4 week course of oral ciprofloxacin
Management of chronic prostatitis? (4)
NSAIDs + paracetamol for pain relief
Stool softener
Alpha-blocker if significant LUTS
Single course of Abx if symptoms present < 6 months
Risk factors for prostate cancer? (4)
Age
Black ethnicity
Family history
Increasing BMI
Options for symptomless local prostate Ca?
Watchful waiting/active surveillance
Radical prostatectomy
Radiotherapy
Options for symptomatic prostate Ca? (2)
Hormonal treatments:
LHRH analogues e.g. goserelin
Anti-androgens e.g. cyproterone acetate
Radical prostatectomy
Three main indications for anti-androgens in prostate Ca
To prevent testosterone flare symptoms during initiation with LHRH analogues
As monotherapy treatment for prostate Ca
In combination with LHRH analogues for maximum blockade
Role of bisphosphonates in prostate Ca?
Offer to patients treated with androgen deprivation therapy
Management of bony mets? (3)
Local radiotherapy
Corticosteroids
Strontium ranelate
First-line investigation of suspected prostate Ca?
Multiparametric MRI
NICE prostate cancer referral guidelines?
50-69 should be referred if PSA greater than 3 or abnormal DRE
