Thank you for re this pleasant 78-year-old male who was seen regarding difficulty with urination. He has had a previous TUPR in May of 1997. The patient reports difficulty in ini his urination, especially in the morning. He has noc x 2-4. He thinks he empties completely. There is no dy, no he.
Past medical history includes hypert. Allergies nil. Medication includes Zestril.
Physical ex revealed a 78-year-old male in no ac di. Head and neck and chest are clear. Ab exam revealed no masses, no tenderness and no or. Ge were normal. DRE shows a fairly small pr from previous TUPR.
To recap, Mr. ******* is a 78-year-old male with some increasing ob symptoms following a TUPR 1½ years ago. The di diagnosis would include ure ste or a bladder neck contracture. I will arrange for a cy for de diagnosis and then he will be seen for further management.