Dr Imogen Patterson provides specialist assessment and evidence-based care for benign prostate conditions, elevated PSA and prostate cancer, with personalised treatment guided through multidisciplinary collaboration.
The prostate is a small gland that sits below the bladder and surrounds the urethra. Several different conditions can affect the prostate, including benign enlargement, inflammation, elevated prostate-specific antigen (PSA) levels and prostate cancer.
Many prostate conditions produce similar urinary symptoms. Careful clinical assessment helps determine whether symptoms are related to benign prostate conditions, an elevated PSA, or the presence of prostate cancer.
Prostate conditions may present with urinary or systemic symptoms. Common signs that may require assessment include:
Reduced strength of urine flow during urination.
Difficulty beginning urination despite the urge to pass urine.
Needing to urinate more often than usual, particularly during the day.
A sudden and difficult to control need to urinate.
Waking during the night to pass urine.
Visible or microscopic haematuria may require further investigation.
Occasionally associated with prostate inflammation or advanced disease.
A raised prostate-specific antigen level on blood testing.
* Persistent urinary symptoms or an elevated PSA should be assessed by a specialist urological surgeon.
Evaluation of urinary symptoms, medical history and risk factors to assess possible benign or malignant prostate conditions.
PSA testing and blood analysis may help identify prostate enlargement, inflammation or possible prostate cancer. Note that PSA may be in the normal range and still be of clinical concern.
Ultrasound or MRI may be used to assess prostate size, bladder function and structural changes.
When PSA levels remain elevated or imaging findings raise concern, a prostate biopsy may be recommended to confirm or exclude prostate cancer.
Management depends on the underlying diagnosis, PSA results, symptom severity and overall health.
Appropriate when symptoms are mild or when prostate cancer is considered low risk.
Used to control symptoms related to benign prostate conditions.
Recommended when symptoms are significant or cancer treatment is required.
Treatment may be recommended when:
Management decisions are made after careful clinical assessment and discussion.
General guidance may include:
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PSA may rise due to prostate enlargement, inflammation, infection or prostate cancer. Further assessment is required to determine the cause.
No. Many men with elevated PSA do not have prostate cancer, but investigation is important.
A biopsy may be recommended when PSA levels or imaging findings suggest possible cancer.
Not always. Some prostate cancers are monitored with active surveillance depending on risk level.
Monitoring frequency depends on age, risk factors and previous PSA results.
