Patient Note — 139054

4/23/26, 6:39 AM Print Preview [PATIENT_NAME] DOB: [DOB] (51 yo M) Acc No. [ACCOUNT_ID] DOS: 04/21/2026 [PATIENT_NAME] 51 Y old Male, DOB: [DOB] Account: [ACCOUNT_ID]: [PHONE] [ADDRESS] Home: [PHONE] Guarantor: [GUARANTOR_NAME] Insurance: Tricare East PGBA Referring: [PROVIDER_NAME] Appointment Facility: TELE-POTOMAC UROLOGY CENTER-Alex Structured Data: How did you hear about us? : Other; Patient's temperature : 96.9; : 06/17/2022 04/21/2026 TV-F/U : [PROVIDER_NAME], MD Reason for Appointment 1. Lab Review History of Present Illness Testicular Pain: 51 year old male, with testicular pain and fluctuating testosterone. He presents for a televisit. His most recent F/T was 12.7 and 3.3. Albumin 4.8 (low), Testosterone Total was 94.8, LC/MS-MS 4.8 (low), Sex Horm Binding Glob, Serum 17.4 (low), FSH 3.2 (low), LH 3.9 (low), Prolactin 10.7, Estradiol 11.2. US scrotum w doppler(3/11/26) for left testicular pain, concern for torsion from 03/2026 showed no evidence of testicular torsion. Small right sided hydrocele. 0.3 cm left epididymal head cyst. He noticed a lump on his left testicle. On 3/11/26 he had severe pain in left testicle. He went to Malcolm Grow ER. SCRUS was neg for torsion. Small right hydrocele, 3 mm left epididymal head cyst. He was diagnosed with left epiididymitis and started on Levaquin. He still feels someone is "squeezing his testicle". No more testicular pan after extended course of levaquin. Testostorone was 324(2/25/26). 218(2/13/26). His testosterone has been fluctuaring. He has fatigue and reduced libido. No ED. Most recent testosterone was 94.8. He recently had upper respiratory issue. He has had high stress recently. ----------------- Scrotal US: Normal (Mar 2023) Scrotal US (6/14/22): moderate right sided hydrocele, no evidence of intratesticular mass or testicular torsion. Current Medications Taking Creatine - Powder as directed Triamcinolone - Powder as directed DULoxetine HCl 60 MG Capsule Delayed Release Particles 1 capsule Orally Once a day Ebglyss(Lebrikizumab-lbkz) 250 MG/2ML Solution Auto-injector as directed Subcutaneous Rinvoq(Upadacitinib ER) 30 MG Tablet Extended Release 24 Hour 1 tablet Orally Once a day Multivitamin levoFLOXacin 500 MG Tablet 1 tablet Orally Once a day Not-Taking DOXYCYCLINE hyclate 100 mg tablet 1 tab(s) orally 2 times a day Progress Note: [PROVIDER_NAME], MD 04/21/2026 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) Generated for Printing/Faxing/eTransmitting on: 04/23/2026 09:39 AM EDT 1/4 4/23/26, 6:39 AM Print Preview [PATIENT_NAME] DOB: [DOB] (51 yo M) Acc No. [ACCOUNT_ID] DOS: 04/21/2026 Screening Vital Signs Assessments 1.Hypogonadism male - E29.1 (Primary) 2.Testicular pain, unspecified - N50.819 Treatment 1.Hypogonadism male Notes: Fluctuating testosterone levels. Most recent Testosterone was very low at 12. We discussed Aveed and T pellets. According to the AUA Guidelines on Low Testosterone (2018), a total testosterone level below 300 ng/dL is a reasonable