A 60-year-old Hispanic male presents with the chief complaint of decreased urinary flow.

A 60-year-old Hispanic male presents with the chief complaint of decreased urinary flow. The patient

has been experiencing this over the past two years, but for the past two weeks, the symptoms

have increased significantly. The current symptoms are similar to what he experienced in the past.

However, for the past two weeks, he has had increased nocturia, with decreased strength of urinary

flow and slight terminal dysuria. Patient has had no treatment in the past. The nocturia has been very

troublesome over the past two weeks. Yesterday he had significant difficulty in starting his urine flow

and this is interfering with daily activities. He needs to pass urine four to five times every night. He has

been urinating frequently and always needs to know if there are bathrooms around.

Patient does not complain of any other radiating pain. He has had no treatment or diagnostic work

up in the past, but now the symptoms have been increasing in severity. He believes he had a lowgrade

fever yesterday. The patient is not sure what is going on but thinks he may have cancer. He had

significant obstructive symptoms two days ago. Gradual worsening of symptoms has compelled him

to seek medical help now.

PMH

Patient has not sought any medical care for this problem to date. He is being treated for hypertension

and hypercholesterolemia. There is no known history of heart disease, but he was hospitalized five

years ago as a suspected case of angina. He was diagnosed with chest wall syndrome for which he was

treated and then released. There are no recent hospitalizations and no surgeries.

ROS

Denies any other positive review of systems. Denies abdominal pain, nausea or vomiting. No blood in

the stool. No gross hematuria.

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