Patient Note — 255347

4/23/26, 6:48 AM Print Preview [PATIENT_NAME] DOB: [DOB] (59 yo M) Acc No. [ACCOUNT_ID] DOS: 04/06/2026 [PATIENT_NAME] 59 Y old Male, DOB: [DOB] Account: [ACCOUNT_ID] [ADDRESS] Home: [PHONE] Guarantor: [GUARANTOR_NAME] Insurance: CareFirst BCBS PCP: [PROVIDER_NAME] Referring: [PROVIDER_NAME] Appointment Facility: POTOMAC UROLOGY CENTER - Alexandria 04/06/2026 Progress Notes: [PROVIDER_NAME], MD Reason for Appointment 1. surgical consultation/Cath change History of Present Illness General Urology: 59 yM presents today to review renal ultrasound and catheter change. On presentation his Cr was 4.2 (11/2025), His Discharge Cr was 2.4. His Cr was 1.8 (12/05/2025). -------------------------------------------------- Prior Hx: 11/04/2025 Fu for BPH, OAB, and ED Tamsulosin HCl 0.4 MG Capsule 1 cap(s) orally once a day with minimal improvement. Weak stream, nocturia x2. + urge inconti. Interested in maintaining sexual activity. He got PSA from PCP. Not sexually active. Endorses ED. Not interested in discussing today. Denies dysuria, GH, UTIs, history of kidney stones, or FHx of prostate cancer. 12/23/25 Hosp FU for sepsis, UTI, AUR, AKI in the setting of BOO; presents today with a foley catheter in place. Admitted 11/8-11/14 with N/V and generalized malaise. He was tx with IV abx and foley placement, which also improved Cr from 3.5 to 2.4. Advised to continue flomax. 01/06/2026 FU urine retention, elevated PSA, BPH, and OAB 02/10/2026 He has a cath in place. Current Medications Taking Carvedilol 3.125 MG Tablet Oral Tamsulosin HCl 0.4 MG Capsule 1 cap(s) orally once a day Medication List reviewed and reconciled with the patient Past Medical History No Reported Medical History. Medical History Verified. Progress Note: [PROVIDER_NAME], MD 04/06/2026 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) Generated for Printing/Faxing/eTransmitting on: 04/23/2026 09:48 AM EDT 1/4 4/23/26, 6:48 AM Print Preview [PATIENT_NAME] DOB: [DOB] (59 yo M) Acc No. [ACCOUNT_ID] DOS: 04/06/2026 Surgical History Denies Family History Father: deceased Mother: deceased Social History Smoking: no Recreational drug use: no. Exercise: yes. Caffeine: yes, frequency:. Sexually active: no. Screening Allergies N.K.D.A. Hospitalization/Major Diagnostic Procedure Bladder outlet obstruction 11/2025 swollen prostate/inova 3/2026 Vital Signs Assessments 1.Elevated prostate specific antigen (PSA) - R97.20 (Primary) 2.Acute renal failure (ARF) - N17.9 3.Benign prostatic hyperplasia with lower urinary tract symptoms - N40.1 4.OAB (overactive bladder) - N32.81 5.Urinary retention - R33.9 Treatment 1.Elevated prostate specific antigen (PSA) Notes: DRE: PV 100 g. Areas of nodularity noted (11/04/2025). PSA: 19.07 (11/2025), 6.7 (06/2025); 2.3 ng/ml (10/10/2023) 4k score: 28 (11/2025) pMRI (12/2025): No PIRADS 3. Pros vol 52 cc. FQ Resist GNR (01/2026): Negative Cysto, transperineal prostate needle biopsy (03/26): No urethral abnormalities. Prostate median lobe only. Bladder