[Benign prostatic hyperplasia; recommendations for transmural care. Working Group, Dutch College of General Practitioners and Netherlands College of Urologists]. / Benigne prostaathyperplasie; aanbevelingen voor transmurale zorg.

Both the Netherlands College of Urologists (NVU) and the Dutch General Practice College (NHG) in recent years published guidelines for the management of benign hypertrophy of the prostate (BPH). The two differ in a number of respects and are not always consistent. The differences between the GP's and urologists' guidelines are mostly to be attributed to the difference in the patient populations visiting the GP and the urologist, respectively. In order to arrive a better adjustment concerning BPH patients between general practice and specialists, a team composed of NVU and NHG has drawn up 'Recommendations for transmural care'. These recommendations concern four subjects: diagnosis of micturition abnormalities, indication for examination of cancer of the prostate, drug treatment, indications for referring and re-referring of patients with micturition problems.

The effect of transrectal ultrasonography (TRUS) including digital rectal examination (DRE) of the prostate on the level of prostate specific antigen (PSA).

OBJECTIVE: To study the effect of transrectal ultrasonography (TRUS) including digital rectal examination (DRE) of the prostate on serum prostate specific antigen (PSA). PATIENTS AND METHODS: In a diagnostic centre for general practitioners serum PSA was determined in patients before, immediately after, and one week after TRUS including DRE. In a small group of patients PSA was determined at various times after DRE and TRUS. RESULTS: The PSA levels showed a statistically significant rise of 20% immediately after DRE and TRUS. After 7 days the PSA levels had returned to their initial levels. This decrease appeared to occur within the first 24 h. CONCLUSION: When applying the diagnostic triad PSA, DRE and TRUS blood samples for PSA should preferably be taken before DRE and TRUS. If blood samples are taken afterwards, it is safe to do so after seven days.