DOCTORS

referral guidelines for general practitioners

We invite General Practitioners to participate in “U BEAUT,” a survey-based study looking into factors influencing prostate cancer treatment decisions.

We offer general practitioners an evidence-based comparison of surgery and radiotherapy for localised prostate cancer,  developed in association with Radiation Oncologist Dr Michael Ng.  Please complete the survey first, as this will help you understand why the information has been presented in the way that it has.

General Practitioner

Join Our Community

To join our community of General Practitioner referrers, please contact the service by phone (1800 246 779) or pager (03 9387 1000) for urgent appointments, or by fax (03 8686 1427)  for routine consultations.

Haematuria

Both microscopic and macroscopic haematuria require evaluation with cystoscopy and upper tract imaging to rule out malignancy. To this end, please ensure patients obtain the following:

  • Upper tract imaging in the form of CT intravenous pyelogram if renal function allows, or renal tract ultrasound in the case of renal impairment
  • Midstream urine examination and urine culture
  • Urine cytology, x 3 samples
  • PSA in men aged 50 or above

Please click here for more information about bladder cancer.

Kidney and Ureteric Stones

All patients referred with renal or ureteric calculi require a non-contrast CT of the kidneys, ureters, and bladder (CT KUB). The only exceptions are patients with obvious contraindications such as pregnancy.

Plain abdominal X-ray (KUB) is useful for identifying uric acid stones, which may be amenable for dissolution therapy. These stones are visible on CT but not on X-ray.

In addition to imaging, please arrange:

  • Serum urea and electrolytes, calcium, phosphate, uric acid, and parathyroid hormone levels
  • Urine pH, microscopy and culture

Please click here for more information about kidney stones.

Urinary Symptoms in Men

Treatment for men with BPH depends upon the severity of symptoms and anatomical factors such as prostate size. To facilitate assessment, please refer patients with:

  • Renal tract USS, including prostate volume and pre- and post-void bladder volumes
  • Midstream urine examination and urine culture
  • PSA, urea and electrolytes

More information about benign prostate enlargement can be found by clicking here.

PSA Screening

Men referred for an elevated PSA or abnormal digital rectal examination findings would benefit from:

  • Free/total PSA ratio, to aid assessment of malignancy risk
  • Midstream urine examination and urine culture, to exclude false-positive PSA levels from concurrent infection

Please ensure the patient abstains from sexual activity for 48 hours prior to PSA testing.

Please do not order investigations such as MRI and PET-PSMA. These will be ordered, if necessary, after initial assessment and consultation with the patient.

Kidney Mass

A general practitioner may detect a kidney mass incidentally during workup for other conditions, such as with spinal imaging for back pain.

Please arrange a triple-phase CT scan of the abdomen and pelvis to further characterise the mass. In addition, the patient may require a renal tract ultrasound in the case of a complex cystic mass or angiomyolipoma.

Please click here for more information about kidney cancer.

Testis Mass

All patients with suspected testicular malignancy should have an ultrasound of the scrotum and a chest X-ray.

In addition, please arrange serum tumour markers (AFP, bHCG, LDH) as well as baseline blood tests (FBE, UEC, LFTs).

For more information about testis cancer, click here.