Audio_Uro_Hp_12

HISTORY: The above patient was seen at your request. The patient is a 72-year-old African-American man who has been seen for elevated PSA level. The patient believes that about five years ago, he underwent a biopsy of the prostate, which was negative. He does not have any symptoms of weight loss or bone related pain. The patient also takes Hytrin and he has nocturia about twice per night.

PAST MEDICAL HISTORY: Glaucoma and hyperlipidemia.

PAST SURGICAL HISTORY: Skin grafting due to having burns.

MEDICATIONS: Lipitor and Hytrin.

ALLERGIES: No known drug allergies.

SOCIAL HISTORY: He is a non-smoker.

FAMILY HISTORY: Noncontributory.

REVIEW OF SYSTEMS: Otherwise negative.

LABORATORY DATA: PSA in September 2005 was 4.58, and in May 2005, was 5.03.

PHYSICAL EXAMINATION: The patient was in no acute distress. He was alert, awake and oriented. There was no CVA tenderness. The abdomen was soft. The kidneys and bladder were not palpable. There was no inguinal adenopathy or inguinal hernia. The penis was uncircumcised and the meatus was normal. The testes were without masses, and scrotum and epididymides were normal. Digital rectal examination showed that the prostate was moderately enlarged and slightly more firm to palpation on the right side. The seminal vesicles were not palpable. The anal sphincter tone was adequate.

IMPRESSION AND PLAN: I have recommended that he will have repeat transrectal biopsy of the prostate. The instructions prior to the biopsy were reviewed with the patient. He will be followed up in a few weeks for the biopsy.