Patient Note — 258207

progress_notes_258207_1_deid.txt

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Demographics & Encounter

Patient ID258207 (PHI redacted)
Age / Gender55 / Male
Date of Service2026-03-24
ProviderNone
FacilityPOTOMAC UROLOGY CENTER - Manassas
PayerSentara Health
Reason1. 6 MONTH F/U

Diagnoses

N40.1 Benign prostatic hyperplasia with lower urinary tract symptoms
Z12.5 Screening for prostate cancer

Medications

Tamsulosin HCl 0.4 MG Capsule 1 cap(s) orally once a day Atorvastatin Calcium Cefdinir Ventolin HFA(Albuterol Sulfate HFA) Cefuroxime Axetil predniSONE Trelegy Ellipta(Fluticasone-Umeclidin-Vilant) 200-62.5-25 MCG/ACT Aerosol Powder Breath Activated Inhalation Azithromycin Levothyroxine Sodium Metoprolol Succinate ER Medication List reviewed and reconciled with the patient Progress Note: STELLA Y BASOAH 03/24/2026 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) Generated for Printing/Faxing/eTransmitting on: 04/14/2026 04:23 PM EDT 1/4 4/14/26, 1:23 PM Print Preview [PATIENT_NAME] DOB: [DOB] (55 yo M) Acc No. [ACCOUNT_ID] DOS: 03/24/2026

Past Medical History

  • High blood pressure
  • High cholesterol
  • Thyroid disease

Vitals

RR 18.0
HR 110.0
BP 122/82
BMI 26.39
WEIGHT 149 lbs
HEIGHT_IN 63.0

Clinical Summary (HPI)

General Urology: 54yM with LUTS presents today for 6 month fu, as he continues with Tamsulosin. He c/o urinary urgency, little urine output, nocturia x4-5. He says the medication is no long helpful, after 1 month. He is taking tamsulosin every morning with mild retrograde ejaculation, not bothersome. --------------------- He reports urinary frequency and weak stream. Denies any dribbling, not using pads. He reports he was hospitalized 2 months ago for asthma, and notes that his urinary sx have been worse since. Denies dysuria or GH. No recent UTIs. He has not tried any medications. --------------------- Prior work-up: PSA (09/2025): 2.61 (reviewed and interpreted) Urocuff (09/2205): PVR 43 ml, VV 288 ml, Qmax 12.1, staccato voiding pattern (reviewed and interpreted) UAmicro (08/2025): RBC 3-10, UCx: NG. (reviewed and interpreted) Labs (06/2025): WBC 11.6, Cr 0.5, BMP (06/2025): Cr 0.3, BUN 24, UA (06/2025): Ket 15, PH 7.5, Pro Trace, RBC 51-100, WBC 6-10, HbA1c 5.9, D-Dimer (09/2024); 0.7.

Raw Note (de-identified preview)

4/14/26, 1:23 PM Print Preview [PATIENT_NAME] DOB: [DOB] (55 yo M) Acc No. [ACCOUNT_ID] DOS: 03/24/2026 [PATIENT_NAME] 55 Y old Male, DOB: [DOB] Account: [ACCOUNT_ID] [ADDRESS] Home: [PHONE] Guarantor: [GUARANTOR_NAME] Insurance: Sentara Health Plans (FNA Optima) PCP: [PROVIDER_NAME] Referring: [PROVIDER_NAME] Appointment Facility: POTOMAC UROLOGY CENTER - Manassas 03/24/2026 Progress Notes: STELLA Y BASOAH Reason for Appointment 1. 6 MONTH F/U History of Present Illness General Urology: 54yM with LUTS presents today for 6 month fu, as he continues with Tamsulosin. He c/o urinary urgency, little urine output, nocturia x4-5. He says the medication is no long helpful, after 1 month. He is taking tamsulosin every morning with mild retrograde ejaculation, not bothersome. --------------------- He reports urinary frequency and weak stream. Denies any dribbling, not using pads. He reports he was hospitalized 2 months ago for asthma, and notes that his urinary sx have been worse since. Denies dysuria or GH. No recent UTIs. He has not tried any medications. --------------------- Prior work-up: PSA (09/2025): 2.61 (reviewed and interpreted) Urocuff (09/2205): PVR 43 ml, VV 288 ml, Qmax 12.1, staccato voiding pattern (reviewed and interpreted) UAmicro (08/2025): RBC 3-10, UCx: NG. (reviewed and interpreted) Labs (06/2025): WBC 11.6, Cr 0.5, BMP (06/2025): Cr 0.3, BUN 24, UA (06/2025): Ket 15, PH 7.5, Pro Trace, RBC 51-100, WBC 6-10, HbA1c 5.9, D-Dimer (09/2024); 0.7. Current Medications Taking Tamsulosin HCl 0.4 MG Capsule 1 cap(s) orally once a day Atorvastatin Calcium 20 MG Tablet Oral Cefdinir 300 MG Capsule Oral Ventolin HFA(Albuterol Sulfate HFA) 108 (90 Base) MCG/ACT Aerosol Solution Inhalation Cefuroxime Axetil 250 MG Tablet Oral predniSONE 20 MG Tablet Oral Trelegy Ellipta(Fluticasone-Umeclidin-Vilant) 200-62.5-25 MCG/ACT Aerosol Powder Breath Activated Inhalation Azithromycin 250 MG Tablet Oral Levothyroxine Sodium 75 MCG Tablet Oral Metoprolol Succinate ER 25 MG Tablet Extended Release 24 Hour Oral Medication List reviewed and reconciled with the patient Progress Note: STELLA Y BASOAH 03/24/2026 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) Generated for Printing/Faxing/eTransmitting on: 04/14/2026 04:23 PM EDT 1/4 4/14/26, 1:23 PM Print Preview [PATIENT_NAME] DOB: [DOB] (55 yo M) Acc No. [ACCOUNT_ID] DOS: 03/24/2026 Past Medical History High blood pressure. High cholesterol. Thyroid disease. Surgical History eye surgery 224 Family History Father: deceased Mother: deceased Social History Smoking: no Recreational drug use: no. Exercise: yes. Caffeine: no. Sexually active: yes. Occupation: no. Screening Allergies N.K.D.A. Hospitalization/Major Diagnostic Procedure pt went to sentara due to breathing issues. 03/2026 Review of Systems 11 system Review of Systems completed in the chart and all pertinent positives and negatives reviewed with the patient...na. Vital Signs RR: 18, HR: 110, BP: 122/82 mm Hg, Ht: 63, Wt: 149 lbs