Case 38-1967

Presentation of Case* First admission. A seventy-two-year-old man was admitted to the hospital because of difficulty with urination.He had been well until two months previously, when there was the onset of frequency of urination, with nocturia, hematuria and dysuria. He had had no recent change in weight. There was no history of anorexia, fever, chills, pain in the chest, dyspnea or a cough.The patient did not appear acutely ill. The cervical veins were flat. A Grade 1 apical systolic murmur was heard. The lungs were clear. Moderate suprapubic tenderness was elicited, and the bladder was distended half way . . .