One Stop Prostate Clinic

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Your GP has referred you to the urology department; this information leaflet is designed to help you prepare for your appointment in the one stop prostate clinic.

What is the One-Stop Prostate Clinic?
The clinic has been designed to help you get quicker access to a diagnosis. You will have the relevant tests and see health care professionals in one day rather than having to come back for separate appointments.

Why have I been referred to this clinic?
Patients are referred for a number of reasons, the most common being a raised PSA levels in your blood. PSA stands for prostate- specific antigen and it is a protein produced by the prostate. All men have a small amount of PSA in their blood and the levels usually increase with age. If you are taking Aspirin, Warfarin , Clopidogrel or Phenindione it is important that you let us know as soon
as possible, as there is a risk of bleeding after the procedure.

• If you take Aspirin or Clopidogrel you need to stop this medication 7 days prior to the procedure.
• If you take Warfarin or any other blood thinning medication you will need to stop this prior to the procedure. You will be asked to attend an outpatient clinic (The bridging clinic) to monitor
your INR and review your medication prior to the biopsy.

What happens in the One Stop Prostate Clinic?
You will have two separate appointments on the same day:
• A clinical assessment by a consultant / clinical nurse specialist.
• An ultrasound guided prostate biopsy.

The clinical assessment clinic is held in the main outpatient department- level 2- please book in at main reception. The Biopsy clinic is held in the Treatment centre.

Clinical assessment
Please attend the assessment with a full bladder as a flow test will be performed and a sample of your urine will be tested for signs of infection. Your blood pressure will be recorded and a blood sample may be taken. A short medical history will be taken. At this appointment your PSA level and MRI scan report and your symptoms will be discussed. Any medical conditions will be assessed and your questions will be answered.

Prostate Biopsy
You will be given antibiotics – Ciproxin 500mg at your clinical assessment appointment; this is to reduce the risk of infection. You must take the first tablet 2 hours prior to your biopsy appointment, another tablet that evening, then the following morning and evening for a further two/four days (as instructed by the Consultant or Specialist Nurse). Please advise the medical team if you are allergic to anything. You will be asked to change into a hospital gown, removing all your clothes from the waist down. Please bring a dressing gown with you as you may have to wait
for a few minutes. Once you are changed you must empty your bladder before coming into the examination room.

The Consultant/Specialist will explain the procedure to you after which you will sign a consent form. Even after this form has been signed you can ask to stop the procedure at any time. The procedure involves gently inserting an ultrasound probe into your rectum (back passage) to allow the consultant / specialist to see the prostate and take approximately ten biopsy samples of the prostate tissue, which will enable a diagnosis to be made. You will be given an injection of local anaesthetic to make the procedure more comfortable.

The examination will take approximately 30 minutes. Tissue samples from your prostate will be sent to the laboratory to be analysed. Once the procedure has finished you will be asked to get changed and wait until the Nurse discharges you. You may wish to bring a partner or family member with you, as it is not always possible to remember exactly what has been said.

Please arrange for someone to drive you home after your biopsy. Please discuss all day parking costs with your nurse specialist.

• It is common to see blood in your urine, semen or when you have your bowels open – this may last several days and occur up to eight weeks after the biopsy. If you experience severe pain in your back passage or see large amounts of blood in your urine, semen or when you have your bowels open, you should first seek advice from your GP or go to A&E.
• If you develop a temperature, feel unwell or shivery, have pain on passing urine or have foul smelling urine, please contact your GP as you may require further antibiotic treatment.
• Your urine flow may be slower following the procedure, if you are unable to pass urine seek medical advice.
• To help prevent any problems occurring it is important that you drink plenty of fluids to ensure that any blood in your urine is flushed out.
• You can eat and drink normally before and after your biopsy.

Next steps:
The biopsy results will take about 7- 10 days. The results will be discussed at a multidisciplinary meeting and a plan of care will be agreed. You will receive your results from the Clinical Nurse Specialist, either at a telephone consultation or in an outpatient clinic. The plan will be agreed with you and any further investigations will be discussed and arranged.

Telephone contact numbers:

MacMillan Uro-Oncology ANP 01908 996901 or bleep 1400 via main hospital switchboard ( 01908 660033)
Cancer pathway navigator 01908 996903
Pathway co-ordinators for consultants: 01908 996763 or 01908 996777

Please do not hesitate to contact any of the above if you have any queries regarding appointments, the procedure and follow-up.