Urology

Question 1

Prostate cancer investigations

Answer 1

PSA - 2 week wait if 3+ and under 70 or 5+ if over 70
U&Es - kidney dysfunction if obstructed
Urinalysis for infectious causes
Multiparametric MRI for lesion
TRUS biopsy for Gleason grading
MRI/CTAP for further staging + mets
Low risk Gleason <7, high >7

Question 2

Prostate cancer treatment

Answer 2

*Active surveillance
*Brachytherapy (cystitis, proctitis)
*External beam radiotherapy (rectum or colon cancer)
*Radial prostatectomy - prostate, seminal vesicles, lymph nodes (incontinence, impotence)