CC: Up multiple times at night to urinate but only dribbles, lightheaded when standing up, sometimes can’t make it to the bathroom in time, difficulty with intimacy. HPI: 65 year old white male...

CC:  Up multiple times at night to urinate but only dribbles, lightheaded when standing up, sometimes can’t make it to the bathroom in time, difficulty with intimacy.

HPI:  65 year old white male present to clinic today with above complaints.  Pt with long h/o UTIs and one episode of sepsis.  Treated 2 weeks ago with Cipro 250 mg BID for 3 days.  New complaint of erectile dysfunction.  Denies fever, chills, nausea, vomiting, abdominal pain, diarrhea, constipation, anorexia.  Feels light headed when getting out of bed, but it resolves after a minute.  Has not fallen.  Denies spinning sensation.  Denies chest pain, SOB, palpitations or diaphoresis.

PmHx:  HTN, chronic UTIs, DM type 2, obesity, OA, insomnia

 Meds:                Metformin 1000 mg BID                             Terazosin 10 mg daily

                            Amitriptyline 25 mg qhs                              Metoprolol succinate 50 mg daily

                            Ibuprofen 800 mg BID                                  Claritin D (24 hour) 1 tablet daily

Allergies:  NKDA, cat dander

 Vital Signs:  BP = 110/60                HR = 65                RR = 18                Wt = 115.2 kg                    Ht = 6’0”

 Physical Exam:  no abnormalities

 Labs:  urine negative for glucose, nitrites, leukocyte esterases, WBC, RBC; trace bacteria present

What diagnostic testing is appropriate for this patient?  Support your choice