Quote:
Originally Posted by admin  Yesterday a man in his fifties asked for a quiet word with me. I took him into the consultation room and we chatted for a while. His experience that day was as follows.......
He had been having "water-works" problems, and had gone to his Dr's surgery to get an appointment with his GP. The receptionist - I checked it wasn't the nurse, no it was the receptionist - asked him what his symptoms were. He told her (as he told me) he was: -
1. Feeling like he wanted to go the the loo to urinate a lot, even during the night
2. He found it difficult to pass water when he tried, and was straining a lot
3. He was getting some pain from this, from his lower abdomen
She told him he didn't need an appointment, and he should call back later that day with a urine sample. The receptionist then "put one of those sticks in it" and told him there was nothing to worry about, he didn't have an infection, and didn't need to see the doctor. He left the surgery.
He then came to see me as he was still concerned. He asked me all the obvious questions you have all probably heard many times before, so I won't bother to list them.
I obviously suspected a prostate problem (BPH etc) and told him a few things, one of them being to make sure he did see his GP - whatever the receptionist said.
I still get a slight shock with this job from time to time.......... |
These symptoms along with increased urgency to urinate, e.g. cannot wait until he can get to a restroom, and decreased stream are classic symptoms of benign prostatic hyperplasia (BPH). It is probably good to rule out a urinary tract infection, however if no burning sensation on urination and no posterial flank pain, it is probably unlikely. A urinalysis with negative bacteria and leukocyte esterase would rule this out pretty easily. Not sure why you are shocked, you should hear some of the things patients tell me. This pt simply needs an alpha blocker (most cost effective tx) or tamsulosin trial and will probably find improvement in a relatively short period of time.