Differential Diagnosis for a 69-year-old man with nocturia and post-micturition dribbling
- Single most likely diagnosis
- Benign Prostatic Hyperplasia (BPH): This condition is common in older men and can cause urinary frequency, nocturia, and post-void dribbling due to bladder outlet obstruction.
- Other Likely diagnoses
- Overactive Bladder (OAB): Characterized by urgency, frequency, and nocturia, OAB could contribute to the symptoms, especially if the patient experiences urgency that wakes him up at night.
- Detrusor Overactivity: Similar to OAB, detrusor overactivity can lead to nocturia and frequency, and might be a contributing factor to the patient's symptoms.
- Urinary Tract Infection (UTI): Although less common in men, UTIs can cause frequency, urgency, and nocturia, and should be considered, especially if other symptoms like dysuria or hematuria are present.
- Do Not Miss diagnoses
- Prostate Cancer: While less likely than BPH, prostate cancer can cause similar urinary symptoms and is a critical diagnosis not to miss due to its potential impact on mortality.
- Diabetes Mellitus: Uncontrolled diabetes can lead to polyuria, causing nocturia and frequency. Missing this diagnosis could have significant implications for the patient's health.
- Sleep Apnea: Nocturia can be a symptom of sleep apnea, which is associated with significant cardiovascular and other health risks if left untreated.
- Rare diagnoses
- Neurogenic Bladder: Conditions affecting the spinal cord or brain, such as multiple sclerosis, Parkinson's disease, or spinal cord injuries, can lead to neurogenic bladder, causing a variety of urinary symptoms including nocturia and incontinence.
- Urethral Stricture: A narrowing of the urethra can cause obstructive urinary symptoms, including post-void dribbling, and is a rare but possible cause of the patient's symptoms.