Clinical Guideline Pathway for Management of BPH

GP Assesses Patient

History IPSS Score Rectal examination of prostate (DRE) U+E and PSA tests Flow rate and residual volume scan where possible

Options Management by GP in community (see IPSS notes below)

Referral to Urology Dept

Normal DRE and PSA

Abnormal DRE or PSA

IPSS Score Mild IPSS<7 Flow rate>15mls/s Residual vol <100mls

Management Watchful waiting

Eligible for Shared Care Prostate clinic

Please send referral with all investigations and results

REFER TO MR DAWSON FOR ONESTOP PROSTATE BIOPSY

Moderate IPSS 7-20 Flow rate<15mls/s Residual vol<200mls Severe IPSS>20 Flow rate<10mls/s Residual vol>200mls

Alpha blockers (e.g. Tamsulosin)

Refer to Urology Dept