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The patient is a 55 year old man visiting his primary care physician for lower urinary tract symptoms including frequency, urgency, weak stream, incomplete emptying and intermittent flow for the past 9 months. Further evaluation revealed:
IPSS score : 15
Post-void residual: 70 mL
Prostate volume (TRUS): 60 mL
Prostate-specific antigen (PSA) level: 3.2 ng/mL
10 mL/sec of maximum flow rate when urine volume was 130 mL
He is otherwise healthy only using Vit D 1000 units daily. His recent blood chemistry (3 days ago) was normal:
Hgb: 13.5 g/dl
WBC: 135000 /mm3
Plt: 350000 /ml
PT: 11 second
PTT: 35 second
INR: 0.9
Creatinine: 0.5 mg/dl
BUN: 10 mg/dl
U/A:
Color: yellow
Appearance: cloudy
PH: 5.3
Specific gravity: 1.010
Glc: 100
Nitrite: negative
Ketone: none
Leukocyte esterase: negative
RBC: negative
WBC: 2 WBCs/hpf
U/C: negative