COMPREHENSIVE I-HUMAN WEEK#7 a 52-
Year-Old Male Patient with Peeing Problem
CASE STUDY ANALYSIS (Class 6531)
Chamberlain
1. PATIENT BIODATA
Category Details
Name Robert Earl Thompson
Age 52 years
Gender Male
Race/Ethnicity African American
Marital Status Married (26 years)
Occupation Construction Site Supervisor
Insurance UnitedHealthcare PPO
Primary Care Physician Dr. James Harrison
Date of Visit March 19, 2026
,Category Details
Time of Visit 11:15 AM
Setting Primary Care Clinic
2. CASE INTRODUCTION
Robert Thompson is a 52-year-old African American male, construction site supervisor by
occupation, who presents to his primary care clinic with a 5-month history of progressively
worsening urinary symptoms. He reports increasing difficulty initiating urination, describing a weak
stream that "just trickles out," significant straining to void, and a persistent sensation of incomplete
bladder emptying. Over the past three months, he has developed nocturia (waking 3-4 times
nightly), urinary frequency during the day (every 1½-2 hours), and post-void dribbling that soils his
underwear. He denies hematuria or dysuria but admits to feeling "frustrated and embarrassed" by
the increasing frequency of urination, which has begun to impact his work performance on
construction sites where bathroom access is limited. He also reports noticing that his ejaculate
volume has decreased significantly. The patient has a history of well-controlled hypertension
diagnosed 5 years ago and hyperlipidemia diagnosed 3 years ago. He has no prior history of urologic
problems.
3. CHIEF COMPLAINT (CC)
"Doc, I'm having trouble with my water. I can't pee like I used to. It takes forever to start, it's just a
dribble, and I feel like I can never empty my bladder. I'm up all night going to the bathroom, and it's
getting embarrassing at work."
4. QUESTIONS AND ANSWERS DURING FULL HISTORY
Q: "Can you walk me through what happens when you try to urinate?"
A: "I stand there at the urinal and nothing happens for what feels like forever—maybe 30-45
seconds. Then it finally starts, but it's just a weak stream, more like a trickle. I have to push and
strain to get it out, and even when I think I'm done, I feel like there's still some left. A few minutes
later, I feel a few drops in my underwear."
Q: "How often are you urinating during the day and night?"
A: "During the day, probably every hour and a half to two hours. At work, it's hard because I can't
just walk off the job site whenever I need to go. At night, I'm up 3 or 4 times. My wife is losing sleep
too."
Q: "Have you noticed any blood in your urine?"
A: "No, never. It's always clear or yellow—looks normal."
, Q: "Any pain or burning when you urinate?"
A: "No pain, no burning. Just hard to get it started and keep it going."
Q: "Have you had any fevers, chills, or back pain?"
A: "No fevers. My lower back aches sometimes from work, but nothing different than usual."
Q: "Have you ever had this problem before?"
A: "Never. This started about 5 months ago and just keeps getting worse. At first I thought it would
go away, but it hasn't."
Q: "Are you sexually active? Any problems with erections or ejaculation?"
A: "Yes, still active with my wife. Erections are fine. But I've noticed that when I ejaculate, there's
hardly anything there—it's almost nothing. My wife noticed too and asked if something was wrong."
Q: "Do you have any family history of prostate problems or prostate cancer?"
A: "My dad had prostate issues in his 60s—he had some kind of surgery. My uncle on my dad's side
died of prostate cancer at 68. My older brother is 55 and fine."
Q: "What medications are you taking?"
A: "I take lisinopril for my blood pressure and atorvastatin for cholesterol. Also a baby aspirin every
day. Sometimes ibuprofen for my back after a long day."
Q: "Do you take any over-the-counter medications or supplements?"
A: "I take a multivitamin. A guy at work told me to try saw palmetto for my prostate. Been taking it
about 2 months, but I don't think it's helping at all."
Q: "How much do you drink during the day? Any caffeine or alcohol?"
A: "I drink a lot of coffee on the job—probably 4-5 cups a day. Maybe a couple of sodas. I have a
beer or two on weekends, that's it."
Q: "Have you noticed any unintended weight loss?"
A: "No, my weight's been steady around 235."
Q: "Any numbness or tingling in your legs or feet?"
A: "No, nothing like that."
Q: "Have you ever had a PSA test?"
A: "No, never. My last doctor mentioned it a few years ago, but I never got it done."
5. DETAILED HISTORY
Robert reports his urinary problems began approximately 5 months ago with subtle changes—a
slightly weaker stream and occasional hesitancy that he initially dismissed as "getting older." Over
the subsequent months, symptoms have progressively worsened. He now describes significant
hesitancy (30-45 seconds to initiate flow), a weak stream he characterizes as a "trickle," and the
Year-Old Male Patient with Peeing Problem
CASE STUDY ANALYSIS (Class 6531)
Chamberlain
1. PATIENT BIODATA
Category Details
Name Robert Earl Thompson
Age 52 years
Gender Male
Race/Ethnicity African American
Marital Status Married (26 years)
Occupation Construction Site Supervisor
Insurance UnitedHealthcare PPO
Primary Care Physician Dr. James Harrison
Date of Visit March 19, 2026
,Category Details
Time of Visit 11:15 AM
Setting Primary Care Clinic
2. CASE INTRODUCTION
Robert Thompson is a 52-year-old African American male, construction site supervisor by
occupation, who presents to his primary care clinic with a 5-month history of progressively
worsening urinary symptoms. He reports increasing difficulty initiating urination, describing a weak
stream that "just trickles out," significant straining to void, and a persistent sensation of incomplete
bladder emptying. Over the past three months, he has developed nocturia (waking 3-4 times
nightly), urinary frequency during the day (every 1½-2 hours), and post-void dribbling that soils his
underwear. He denies hematuria or dysuria but admits to feeling "frustrated and embarrassed" by
the increasing frequency of urination, which has begun to impact his work performance on
construction sites where bathroom access is limited. He also reports noticing that his ejaculate
volume has decreased significantly. The patient has a history of well-controlled hypertension
diagnosed 5 years ago and hyperlipidemia diagnosed 3 years ago. He has no prior history of urologic
problems.
3. CHIEF COMPLAINT (CC)
"Doc, I'm having trouble with my water. I can't pee like I used to. It takes forever to start, it's just a
dribble, and I feel like I can never empty my bladder. I'm up all night going to the bathroom, and it's
getting embarrassing at work."
4. QUESTIONS AND ANSWERS DURING FULL HISTORY
Q: "Can you walk me through what happens when you try to urinate?"
A: "I stand there at the urinal and nothing happens for what feels like forever—maybe 30-45
seconds. Then it finally starts, but it's just a weak stream, more like a trickle. I have to push and
strain to get it out, and even when I think I'm done, I feel like there's still some left. A few minutes
later, I feel a few drops in my underwear."
Q: "How often are you urinating during the day and night?"
A: "During the day, probably every hour and a half to two hours. At work, it's hard because I can't
just walk off the job site whenever I need to go. At night, I'm up 3 or 4 times. My wife is losing sleep
too."
Q: "Have you noticed any blood in your urine?"
A: "No, never. It's always clear or yellow—looks normal."
, Q: "Any pain or burning when you urinate?"
A: "No pain, no burning. Just hard to get it started and keep it going."
Q: "Have you had any fevers, chills, or back pain?"
A: "No fevers. My lower back aches sometimes from work, but nothing different than usual."
Q: "Have you ever had this problem before?"
A: "Never. This started about 5 months ago and just keeps getting worse. At first I thought it would
go away, but it hasn't."
Q: "Are you sexually active? Any problems with erections or ejaculation?"
A: "Yes, still active with my wife. Erections are fine. But I've noticed that when I ejaculate, there's
hardly anything there—it's almost nothing. My wife noticed too and asked if something was wrong."
Q: "Do you have any family history of prostate problems or prostate cancer?"
A: "My dad had prostate issues in his 60s—he had some kind of surgery. My uncle on my dad's side
died of prostate cancer at 68. My older brother is 55 and fine."
Q: "What medications are you taking?"
A: "I take lisinopril for my blood pressure and atorvastatin for cholesterol. Also a baby aspirin every
day. Sometimes ibuprofen for my back after a long day."
Q: "Do you take any over-the-counter medications or supplements?"
A: "I take a multivitamin. A guy at work told me to try saw palmetto for my prostate. Been taking it
about 2 months, but I don't think it's helping at all."
Q: "How much do you drink during the day? Any caffeine or alcohol?"
A: "I drink a lot of coffee on the job—probably 4-5 cups a day. Maybe a couple of sodas. I have a
beer or two on weekends, that's it."
Q: "Have you noticed any unintended weight loss?"
A: "No, my weight's been steady around 235."
Q: "Any numbness or tingling in your legs or feet?"
A: "No, nothing like that."
Q: "Have you ever had a PSA test?"
A: "No, never. My last doctor mentioned it a few years ago, but I never got it done."
5. DETAILED HISTORY
Robert reports his urinary problems began approximately 5 months ago with subtle changes—a
slightly weaker stream and occasional hesitancy that he initially dismissed as "getting older." Over
the subsequent months, symptoms have progressively worsened. He now describes significant
hesitancy (30-45 seconds to initiate flow), a weak stream he characterizes as a "trickle," and the
