2. HISTORY
• A patient 60y/M, labourer by occupation, presents to the hospital
with the chief complaints:
• Increased frequency of urination since 5 months
• Dribbling of urine since 4 months
• Retention of urine 30 days back.
3. • History of Present Illness-
• As per patient , he was apparently alright 5 months back when he noticed
increased frequency of urination imitially at night and later at daytime. It was
associated with difficulty in passing urine as the patient had to exert excessive
pressure and over time and gradually the flow of urine decreased and thinning
of urinary stream was there.
• With time patient developed hesitancy and dribbling of urine especially at the
end of urination.
• Patient also complained of sensation of incomplete voiding of bladder and
remained unsatisfied after act of urination.
• 30 days back patient went into acute urinary retention for which patient was
catheterised and put on medications and later was given catheter free trial.
• But patient again presented with retention of urine and was again catheterised.
• Not associated with incontinence of urine, fever with chills, vomiting, pain in the
loin region; not associated with haematuria; no h/o wt loss/anorexia and no h/o
bony pain.
4. • Past History- No P/H/O DM/PTB/HTN/COPD or any medical / surgical
illness.
• Personal history-
• Bowel- passing flatus and motion normally.
• Habits- No h/o alcoholism or smoking or tobacco chewing.
Family history- Not significant.
5. Examination
• Patient is fully conscious and well oriented to time place and person and is
lying supine on examination table.
• Patient is of average built.
• P- 70/min regularly regular normovolumic taken in rt radial artery.
• B.P- 140/60 mmhg in rt arm in supine position.
• No icterus/pallor/cyanosis/clubbing
• No cervical/inguinal lymphadenopathy present.
• CVS- S1S2 +
• RS- B/L AE present
• P/A- Soft BS+
6. • Local Examinaiton-
• Inspection-
• Patient is lying in supine position with lower abdomen and genitalia exposed upto mid thigh.
• No scar marks visible over bilateral inguinal regions and hernial sites appear normal.
• No cough impulse seen.
• External genitalia appears normal with penis in midline and testes in scrotal sac.
• Palpation-
• Hernial sites are normal no bulging on coughing.
• Testes are normal in shape and size present in scrotal sac
• Penis is in midline and has a single uretheral meatus which is normal in calibre.
• No inguinal lymphadenopathy present.
• Per Rectal examination-
• Normal anal tone.
• Prostate is palpable and is rubbery in consistency, has smooth surface and rectal mucosa over prostate can be mobilised.
• Median sulcus and lateral lobes palpated and index finger can reach the upper limit of prostate with much difficulty.
• No nodularity palpable.
