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.
