Patient Note — 263588

4/16/26, 12:42 AM Print Preview [PATIENT_NAME] DOB: [DOB] (83 yo F) Acc No. [ACCOUNT_ID] DOS: 04/02/2026 [PATIENT_NAME] 83 Y old Female, DOB: [DOB] Account: [ACCOUNT_ID]: [PHONE] [ADDRESS], [CITY], [STATE]-[ZIP] Home: [PHONE] Guarantor: [GUARANTOR_NAME] Insurance: Medicare VA (Palmetto) PCP: [PROVIDER_NAME] Referring: [PROVIDER_NAME] Appointment Facility: POTOMAC UROLOGY CENTER - Woodbridge 04/02/2026 TV-F/U : [PROVIDER_NAME] Reason for Appointment 1. Blood in urine History of Present Illness UTI: 83 year old female with history of UTI presents via TV for evaluation of gross hematuria. Daughter is providing hx, and she notes that patient developed blood in the urine 3 days after taking her 1 dose of fosfomycin, recomended last visit. Urgent care advised they go to ER and there, pt was treated with IV abx and additional dose of fosfomycin. In addition to GH, pt continues to c/o bladder spasms. Daughter states that no urine labs confirmed UTI. Daughter also mentions that GYN recommends screening for bladder cancer. Smoking HX: quit 50 years ago; 5 pack years ------------------------ She was on Macrobid 10 years ago. ++++++++++ UA/UCx: RBC 20-50 /hpf, NG [12/31/2025]. Atrophic Vaginitis: Also, with history of PMAV. She has not been using Estrace vaginal cream. Current Medications Taking Singulair(Montelukast Sodium) 5 MG Tablet Chewable as directed Orally Dicyclomine HCl 10 MG/ML Solution 1 mL Intramuscular Four times a day Omeprazole 10 MG Capsule Delayed Release 1 capsule 1/2 to 1 hour before morning meal Orally Once a day Methenamine Hippurate 1 GM Tablet 1 tablet Orally Twice a day Estrace(Estradiol) 0.1 MG/GM Cream NO applicator, pea-sized amount at the tip of the finger Vaginal every night Vitamin C 500 MG Tablet Chewable 1 tablet Orally Once a day Fosfomycin Tromethamine 3 GM Packet as directed Orally daily Screening Vital Signs Assessments 1.Gross hematuria - R31.0 (Primary) 2.Urinary tract infection, site not specified - N39.0 3.Postmenopausal atrophic vaginitis - N95.2 Progress Note: [PROVIDER_NAME] 04/02/2026 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) Generated for Printing/Faxing/eTransmitting on: 04/16/2026 03:42 AM EDT 1/3 4/16/26, 12:42 AM Print Preview [PATIENT_NAME] DOB: [DOB] (83 yo F) Acc No. [ACCOUNT_ID] DOS: 04/02/2026 Treatment 1.Gross hematuria IMAGING: CT : Urogram (Abd/Pel) w/wo IV Contrast Notes: According to the AUA Guidelines, this places the patient into a high-risk category. Due to this classification, the patient warrants a full hematuria work-up, consisting of urine culture/PCR, urine cytology, CT Urogram and cystoscopy. The patient was counseled into the potential causes of hematuria including UTI, nephrolithiasis, malignancy, glomerular disorders, and trauma. I will provide a CT order and we will make arrangements to proceed with cystoscopy in the coming weeks Clinical Notes: Pt is on televisit today. We are unable to check urine labs, but daughter makes known that culture was negativ