referral criteria from primary care - benign prostatic hyperplasia

Last edited 03/2021

Specialist referral should be considered for

  • patients with severe symptoms particularly when rapidly progressive

  • where rectal examination is abnormal

  • in complicated BPH e.g. recurrent urinary infections, haematuria, urinary retention, obstructive nephropathy, bladder stones

  • patients with raised PSA

  • patients who fail to respond to drug treatment for BPH

Consider urgent referral guidance re: prostate cancer (2)

  • refer men using a suspected cancer pathway referral (for an appointment within 2 weeks) for prostate cancer if their prostate feels malignant on digital rectal examination

  • consider a prostate-specific antigen (PSA) test and digital rectal examination to assess for prostate cancer in men with:
    • any lower urinary tract symptoms, such as nocturia, urinary frequency, hesitancy, urgency or
    • retention or
    • erectile dysfunction or
    • visible haematuria

  • refer men using a suspected cancer pathway referral (for an appointment within 2 weeks) for prostate cancer if their PSA levels are above the age-specific reference range

Reference: