Genitourinary

Discussion Prompt

65-year-old male presents to your clinic with frequent urination. He complains of painless, frequent urination approximately every 45 minutes to an hour for the past 5 months. He states he hates visiting doctors because they always try to find something wrong with him. His wife made him this appointment, but he thinks his problem is just because he is getting older. He denies any pain on urination or any blood in the urine. He also denies any difficult voiding. No foul odor is in the urine or discharge from the penis. He has tried to reduce his liquid consumption, but it has not made much of a difference. He denies any pelvic pain or rectal pain. He has not had any labs done in the past 5 years. Also, he has not had a physical done in 10 years. Physical exam reveals an African American male in no apparent distress. Abdomen is soft, nontender, no masses or distensions on palp. No hepatosplenomagaly. DRE reveals an enlarged, firm, smooth, symmetrical prostate. Provide the most likely diagnosis based on the HPI and PE. In addition, provide your interpretation of the cues found in the assessment. List at least 3 possible differential diagnoses and justify your rationale. Develop therapeutic plan options based on quality, evidence-based clinical guidelines.