Audio_Uro_Hp_14

HISTORY: He is a 57-year-old man who was seen by the general surgeon for possible right inguinal hernia. He did not seem to have hernia at that time and he was referred to us for his urinary symptoms. The patient used to have nocturia two to three times per night but now he states that his symptoms have fully resolved. He has no nocturia or daytime frequency or urgency. He has not had any dysuria or hematuria.

PAST MEDICAL HISTORY: None.

MEDICATIONS: None.

PAST SURGICAL HISTORY: None.

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: He smokes one-pack of cigarettes a day for more than 30 years.

LABORATORY DATA: BUN 15, creatinine 1.5, and PSA 2.97.

PHYSICAL EXAMINATION: The patient 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 hernia or inguinal adenopathy. The penis and meatus were normal. The testes were without masses. The scrotum and epididymides were normal to examination. The patient absolutely refused to have a digital rectal examination done.

IMPRESSION AND PLAN: Based on his symptoms, no specific treatment will be initiated at this time. The patient is aware that digital rectal examination is recommended to be performed once a year to rule out presence of palpable prostate cancer. He will be followed up in future if necessary.