QuestionSBA
QuestionChoice
Whilst this may explain increased urinary frequency, the chronic history, lack of dysuria/haematuria and the examination findings suggest a malignant process rather than a simple UTI.
10035536
e
Urine MCS
QuestionChoice
This is not an appropriate option as although LUTS might be common in older patients, they have a variety of causes, some of which are serious. Even if caused by BPH, treatment may be considered. This is especially inappropriate based on the examination findings.
10035534
c
Reassure the patient that these are normal symptoms with age
QuestionChoice
If a patient has a prostate which feels malignant on DRE, they should be referred under the suspected cancer pathway. A PSA should not be performed on a patient who had a DRE on the same day and the patient should be referred based on the examination findings alone.
10035532
a
2-week wait referral under suspected cancer pathway
QuestionChoice
A PSA should not be performed on a patient who had a DRE on the same day and the patient should be referred based on the examination findings alone.
10035533
b
Offer same-day PSA testing
QuestionChoice
This is not an appropriate choice as there is no history of haematuria and the examination findings suggest prostate cancer needs to be ruled out before investigating other urological causes.
10035535
d
Refer for cystoscopy
Concept
Chapter
2693
3755
Prostate cancer
Topic
143
Urology
19510
When a prostate feels suspicious for cancer on digital rectal exam (DRE), referral under the suspected cancer pathway should be made based on the examination alone, without performing a PSA on the same day, as the DRE findings take precedence
A 67-year-old male complains of a 6-month history of urinary hesitancy and increased urinary frequency. He states he wakes up approximately 3 times every night to pass urine which he is finding increasingly troublesome. He denies any dysuria or haematuria. On digital rectal examination. a hard, irregular mass is felt on the posterior aspect of his prostate gland.

What is the most appropriate management of this patient?
a