Email: rkooner@stvincents.com.au Phone: 02 8382 6980

Your Details

Tumour Factors - if prostate biopsies have been already done

You may not know some or all of these.

Prostate Factors - please fill in all you know

YES

NO

YES

NO

YES

NO

YES

NO

Local Factors - please fill in all you know

Overweight

Slightly Overweight

Patient Factors

A. Sexual

Good

Average

Below Average

In Relationship

Single

Very Important

Important

Somewhat Important

B. Urinary Status

Continent of Urine

Some Dribbling Post Urination

Incontinent of Urine at Times

High

Medium

Low

C. Bowel Status

YES

NO

YES

NO

High

Medium

Low

D. General Healths

E. Other Factors

Staging Tests - please do not worry if you have not had these done

My team and I will ensure the highest standard of preoperative, operative and and post-operative care to ensure your treatment expectations are fairly met

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