23rd August 2024

A 59-year-old man presents to his GP due to difficulty passing urine

A 59-year-old man presents to his GP due to difficulty passing urine. He reports that over the last 18 months he is passing urine increasingly frequently but only small amounts each time. He has otherwise been well and reports no other symptoms. On examination he has slight shaking in his right hand and dullness to percussion over his abdomen suprapubically. He becomes quite lightheaded on mobilising to the bed to be examined and thus a lying and standing BP is taken which shows a drop of 30 mmHg in systolic BP on standing. What is the most likely diagnosis in this gentleman?

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