Case Study

A 64 year old accountant presents to his GP with concerns about his prostate. 

 

He has heard from friends that prostate checking by PSA blood test is important and a colleague was diagnosed with prostate cancer last year. 

 

He has a family history of cardiac disease in his father who had a myocardial infarction aged 55. He has an uncle with a TURP required at 65. There is no FH of prostate cancer. 

 

He has a slightly reduced urinary stream and gets up 3 times a night to pass urine. He occasionally feels he hasnt emptied his bladder completely and after a session drinking beer 3 weeks ago he urgently needed to empty his bladder, just making it to the toilet in time. 

 

You examine him and find him to be normotensive. Urine dip stick was normal. Abdominal examination suggests there is some bladder distension to palpation. DRE reveals an enlarged prostate with uniform consistency.

 

You ask him to fill in the Prostate Symptom Score: He gets 9 and so is classified as Moderate Lower Urinary Tract Symptom level