Mates™ Urology

Male Assessment Tool with Electronic Support™

Help

  • 1. Prostate Symptom and Quality of Life Scores ?

    In the past Month Not at all Less than 1 in 5 times Less than half the time About half the time More than half the time Almost always
    Incomplete emptying
    Frequency
    Intermittency
    Urgency
    Weak Stream
    Straining
    Total Prostate Symptom Score
      Delighted Pleased Mostly Satisfied Mixed Mostly Dissatisfied Unhappy Terrible
    Quality of Life Score ?
    Total Quality of Life Score
    Calculate Score

    IPSS Score vs Quality of Life Score

    Mild IPSS Score ?
    Moderate IPSS Score ?
    High IPSS Score ?

  • 2. Other Urological Symptoms

    Incontinence Yes No
    Urge Incontinence
    Stress Incontinence
    Overflow Incontinence
    Bed Wetting

    Introduction

    Please record other relevant symptoms here; these will need to be considered when contemplating specialist investigations or a urological referral, there is a free text box for other symptoms you elicit.

    An accessible record of IPSS and other symptoms can be useful when tracking or monitoring a patient over time, sometimes many years.

    Other
    Urological Symptoms ?
    		 Yes No
    Urinary Dysuria
    Haematuria
    Urinary Spraying
    Haematospermia
    Ejaculation Dysfunction / Pain
    Testicular Pain
    Perineum Pain
    Sleep Apnoea
    Erectile Dysfunction

  • 3. Clinical Features ?
    Renal Examination
    Penis Examination
    Testes Examination
    Abdominal Examination
    (DRE) Prostate Examination

  • 4. Personal and Family History ?

    This section provides a reference for further reviews on your patient. Version 2 will present decision support (and patient text) for Sexually Transmitted Disease and links to Cardiovascular Assessment and Alcohol Cessation programmes.
    Cystoscopy
    Surgery TURP
    Radical Prostacetomy
    Bladder Neck Incision
    Bladder Surgery
    Renal Surgery
    Other Surgery
    Vasectomy
    Family Prostate History

Document Library

Clinical Data Section

The four main male genitourinary conditions presenting with symptoms or patient concerns to primary care are:

In version 1 of this decision aid we have concentrated on Prostate Health Assessment. Clearly other conditions, e.g. bladder/testicular cancer or renal diseases, must be considered if the symptoms or results indicate them. Let us look at the prostate first.

Please record other relevant symptoms here; these will need to be considered when contemplating specialist investigations or a urological referral, there is a free text box for other symptoms you elicit. An accessible record of IPSS and other symptoms can be useful when tracking or monitoring a patient over time, sometimes many years.

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This is an assessment of Prostatism and impact on Quality of Life.

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Review patient in 12 months, or prior if any change in symptoms are noted. This is assuming no abnormalities of concern with DRE and Laboratory tests.

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Suggest trial of medication and review in 3 months. This is assuming no abnormalities of concern with DRE and Laboratory tests.

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The QoL score is a reference for future review and should be used in conjunction with your patient's other signs, symptoms and Laboratory results. The purpose of the QoL is to promote a conversation with your patient, "How are you managing now".

This is important data as any family history of prostate cancer in first degree relatives may be relevant, especially when onset is < 55 years. A positive FH will confer a risk to your patient. If no FHx is available (e.g. patient adopted) please assume some risk and act accordingly. We have asked you to record a PH of vasectomy; this is for later analysis.

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Infection and cancer are linked as they both may raise PSA levels; Prostatitis rapidly whereas cancer is a slow and steady increase. Please ensure your patient with a past history of infection is clear of cancer risk.

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Macro or Micro, consider a differential diagnosis renal, bladder or Haematology etc...

Patients with Haematospermia should be evaluated by a Urologist to identify or rule out medical causes. Differential diagnosis; Prostate Cancer, Prostatitis, Urethral Stricture, Coagulation disorder or after Prostate biopsy.

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Any first degree relative with a history of Prostate Cancer confers a significant increased risk of cancer for your patient. In the absence of genetic tests we must assume the risk is real and therefore careful monitoring is a correct response.

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Differentiate epididymitis and other scrotal pain due to varicocele, torsion or rarely poly-artertis nodosa. True testicular pain is very rarely due to cancer, exclude mumps and other viral conditions.

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Consider Prostatitis.

Atherosclerosis may affect both penial and coronary (and other) arteries, and the much smaller penial artery may oclude first. Consider CVD ris assessment.

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Immediate referral required for ultrasound or CTU and Surgical opinion.

Differentiate epididymitis and other scrotal pain due to varicocele, torsion or rarely poly-artertis nodosa. True testicular pain is very rarely due to cancer, exclude mumps and other viral conditions.

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Differential diagnosis of painless mass / swelling includes; Cancer (especially in younger men); Varicocele and Hydrocele. An estimate of testicular size is helpful (orchadometer).

A DRE must accompanied by current PSA testing and results interpreted in respect of expected risk of Prostate cancer. It is important to diagnose cancer as early as possible to allow possible curative treatment. The interpretation of DRE is fully explained in the associated library text, click here for more info.

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Suggest referral to Urology for query biopsy / query Prostatectomy, possible outcomes include BPH, Prostate Cancer or Infection.

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