Physical Examination and Workup
Upon physical examination, the patient is alert and oriented, with no evidence of acute distress. He is afebrile. His heart rate is 74 beats/min, with a regular rate and rhythm, and his blood pressure is 118/75 mm Hg. His lungs are clear to auscultation bilaterally. He exhibits no costovertebral angle tenderness on examination. He is circumcised, with a patent urethral meatus.
The patient's urine is clear and straw-colored. Urinalysis reveals the following:
Urine pH level: 6 (normal value, < 9)
Specific gravity: 1.0101 (reference range, > 1 to < 1.03)
Glucose, ketones, and protein: negative
Blood: 1+ without red blood cell (RBC) casts
Urobilinogen level: Normal
Bilirubin, leukocyte esterase, and nitrites: negative
Urine microscopy demonstrates 0-2 white blood cells per high-power field (HPF), 3-10 RBCs per HPF, and rare bacteria in the urine. Tests for sexually transmitted infections are negative, and the urine culture shows no growth.
A uroflow study reveals a voiding curve with a pattern of start/stop stream and near-complete bladder emptying.
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Cite this: Liana Meffert, Paul Gellhaus. A Sexually Active 29-Year-Old Man With a Weak Urine Stream - Medscape - Apr 26, 2021.
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