Benign Prostatic Hyperplasia: Trouble with Dribbles Chief Complaint… Benign Prostatic Hyperplasia: Trouble with Dribbles Chief Complaint”I’m up four to five times a night feeling that I have to urinate, and then when I get to the bathroom all I do is dribble. I’m very lightheaded when I stand up, and sometimes I don’t make it to the bathroom in time. I have a girlfriend now, but I am finding it difficult to be intimate with her. Also, going to the bathroom all night is really impacting my love life.”HPIJimmy McCracken is a 65-year-old man with a long-standing history of UTIs. He has a history of urosepsis requiring hospitalization. He is being evaluated because of complaints of worsening urinary hesitancy, nocturia, and dribbling. He also has a new complaint of ED. He would like information on prescription medications to treat his urinary symptoms but is not opposed to using natural products.PMHHTNLaminectomy 10 years agoBPHChronic UTIsType 2 DMEDObesityOsteoarthritis (new onset)Cat allergy (new onset)FHEducated through the 12th grade. Father died of massive MI at age 78; mother died of natural causes at age 91.SHWorked for 35 years in a grocery store; retired 7 years ago. Married once. Wife deceased 6 months ago (stroke); one daughter, two granddaughters. Lives alone but is starting to become more socially active. He recently joined a senior dating website and has started dating a 60-year-old woman. He also just adopted a 3-year-old cat from the humane society. Although he reports being allergic to cat dander, he feels that she has added happiness back in to his life and uses medications to keep his allergies under control because he doesn’t want to give up the cat. Used smokeless tobacco × 35 years (quit 10 years ago); heavy ETOH in the past, occasional glass of wine now.ROSIn conversation, he is alert, friendly, and courteous. He has no c/o dyspepsia, dysphagia, abdominal pain, hematemesis, urinary incontinence, or visible blood in the stool.MedsMetformin 1000 mg PO BIDRosuvastatin 20 mg PO once dailyTerazosin 10 mg PO once dailyAmitriptyline 25 mg PO at bedtime (insomnia)Metoprolol succinate 50 mg PO once dailyIbuprofen 800 mg PO BIDClaritin-D 24-hour one tablet PO daily (allergy to cats)AllNKDA; allergic to cat danderPhysical ExaminationGenWhite male in NAD; well-kept appearance; A&O × 3VSBP 110/60 mm Hg, P 65 bpm, RR 18, T 37°C; Wt 115.2 kg, Ht 6’0SkinVertical scars on neck and lower back from laminectomiesHEENTPERRLA; EOMI; TMs intact; nose and throat clear w/o exudate or lesionsNeck/Lymph NodesSupple w/o LAD or masses; thyroid in midlineLungs/ThoraxCTA
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