Rapid Access Prostate Clinic (RAPC)

You have been referred to our Rapid Access Prostate Clinic, or  RAPC as we will refer to is as throughout this brochure, because you have been identified as being at risk of prostate cancer. Your GP or other healthcare professional may have referred you following a raised Prostate Specific Antigen (PSA) blood test level, an abnormal Digital Rectal Examination (DRE) or urinary symptoms.

Your referral will be reviewed by our Advanced Nurse Practitioner (ANP) within 2 working days of being sent. Following this review of information sent in your referral, you will be scheduled for either a telephone assessment consultation with our ANP, or an appointment with the Consultant.

The ANP will assess your medical and surgical history. It is important you have your list of medications ready for this consultation (If you are unsure of your medications or doses, you can ask your pharmacy to print a list for you).

Following this ANP consultation, you may be sent for an MRI scan and/ or straight to see a consultant urologist. You may also be informed your risk of prostate cancer is low and there is need no further tests or investigations.

Our RAPC pathway includes many of our urology consultants. You will likely see 1-2 of these over the course of the pathway and investigations. You may not see the same consultant each visit. Please be reassured that our consultants work as a team and as such, any consultant you see will be fully aware of your case details.

Our RAPC team includes a number of specialist nursing staff also. These include our Advanced Nurse Practitioners (ANPs), and our Uro-oncology Clinical Nurse Specialists (CNS)

Your appointment letter will confirm the exact location of where to attend.

Appointments with the Consultant can last up to 30 minutes. Your appointment will include a Uroflow test and urine test on the same day.

• One family member or friend, if you wish.
• A list of your medications.

The initial fee for the RAPC is €300, and this is inclusive of:

• ANP Telephone Assessment
• 1 Consultant clinic appointment
• Bloods (if required)
• Uroflow & PVR test
• Urine test

Additional clinic visits and investigations will be charged separately as per clinical requirement. You can contact your private health insurance provided to check your level of cover for the above.

PSA is a protein that is produced by prostate cells. A PSA blood test may be raised for a number of different reasons. Such as an enlarged prostate gland (benign prostate enlargement), inflammation, infection, or prostate cancer.

• The uro-flo test measures your maximum urinary flow rate. This involves you passing urine into a special toilet which measures how fast you pass urine.
• After you have emptied your bladder into the flow rate device, we will use an ultrasound bladder scanner to see if your bladder has emptied fully. This is the post void residual measurement.
• This test gives us information about the way your bladder functions. Please note you will need to have a comfortably full bladder for this.

• The doctor will ask you to lie on your side on an examination table, with your knees bent and brought up towards your chest. A gloved finger with lubricating gel will be inserted into your back passage, the gel will make this more comfortable. This examination does not take long. The DRE will help the doctor obtain more information about your prostate and inform potential further investigations.

• A dedicated prostate MRI scan gives a detailed picture of your prostate and surrounding tissues in the pelvis. This will identify if you have any suspicious or abnormal lesions/areas within the prostate. It will help to determine if further investigations may be required, such as prostate biopsy.
• Before an MRI, you will fill out a questionnaire regarding your general health and to ascertain if there is any metalwork in your body. (This includes implanted devices or metal fragments). It is extremely important to tell your medical team if you think you have any metal work in the body prior to an MRI scan.

• The prostate gland is in front of the back passage (rectum). During your prostate biopsy, a doctor will take small samples of tissue from your prostate gland. These samples are then sent to the laboratory to be examined under a microscope by a Consultant Pathologist. Please note, your Consultant Urologist does not carry out this procedure, it is carried out by a Consultant Interventional Radiologist.

• During a Transperineal prostate biopsy, the doctor will guide a thin needle into your prostate through the perineum (the skin between the scrotum and rectum). An ultrasound probe will be inserted into the rectum to scan the prostate. The biopsy will be guided by the MRI scan and ultrasound images. Several samples of the prostate will then be taken through the skin of the perineum.

• This procedure can either be done under Local Anaesthetic (LA) or General Anaesthetic (GA).
• Further information will be provided if you are advised to have a prostate biopsy.