- For a one off uti in otherwise healthy male above the age of 40 do flow rates/residuals via ospic to look for evidence of bph or stricture and assess bladder emptying.
- Do an uss to look for stones, anatomical abnormalities, and screen for tumour (see advice re stones).
- Flexi cystoscopy referral is appropriate if persistent dip haematuria after treatment or risks for tcc such as smoking/industrial exposure, mention of this on referral would be helpful . Cystoscopy not the standard in all cases.
- Ask about uti risk factors such as poor fluid intake, anal sex, previous instrumentation/catheter that might suggest urethral stricture etc.
- Alpha blocker +/- 5 alpha reductase inhibitor if large prostate - see luts guidlines.. if flows/uss normal and one off would not go further unless recurrent problem. then refer refer for further specialist assessment/investigation.
- Younger (<40) more likely to be stones/anatomy and think about std, older more likely to be bph.