With lower availability of urologists in India, with a urologist-to-patient ratio of 1:5,64,1711 patients present with an array of urological conditions to their Physicians.2 While some cases are easy to diagnose, others demand thorough evaluation and careful decision-making.2
BPH/LUTS
Attention should be directed towards ruling out other causes of LUTS, such as UTI, acute prostatitis, malignancy, bladder dysfunction, neurogenic bladder, or obstructive pathologies like urethral stricture disease.3
Identify men with BPH-related LUTS and those at risk of disease progression:4
- Decreased peak urinary flow, PSA level >1.5 ng/mL, and an increased prostate volume (>35 cc) have been identified as the best predictors of clinical progression.4
Men with suspected prostate cancer or severe symptoms and needing emergency intervention (such as surgery) should be promptly referred to a urologist.4
AB: Alpha-blocker; 5ARI: 5-alpha reductase inhibitor; IPSS: International prostate symptom score;
DRE: Digital rectal exam; PSA: Prostate-specific antigen.
Hematuria
It is crucial to assess whether the hematuria is significant.2
- Presence of at least 8 RBCs/HPF in a microscopic urinalysis or a moderate [2+] level of blood on a urine dipstick2
A minimum work up for patients with hematuria includes:2
- Urinalysis to look for protein and casts, to rule out a renal cause
- A urine culture and sensitivity test
- A urine cytology test
- A flat plate x-ray of the abdomen showing the kidneys, ureter, and bladder and an abdominal ultrasound
- Laboratory tests: CBC, electrolytes, creatinine, prothrombin time, INR, and platelet count
Patients with gross or significant microscopic hematuria and a negative urine culture should be referred to a urologist.2
PSA Test Interpretation
Serum PSA may be elevated in patients who have prostatitis, a UTI, or prostate cancer, or those who had recent sexual activity or a recent, vigorous DRE or recent urethral instrumentation.2
Age-specific PSA threshold to detect prostate cancer and PSA velocity cut points2
Alfoo- Relief from LUTS-BPH
ALFOO, containing Alfuzosin molecule, is Anti-BPH which helps in treatment of LUTS due to BPH in Young Sexually Active Male in 40-60 year old age group
