A 69-year-old male presents to the primary care clinic with…
A 69-year-old male presents to the primary care clinic with progressive lower urinary tract symptoms over the past year, including urinary hesitancy, weak stream, nocturia (3–4 times nightly), and a sensation of incomplete bladder emptying. He denies dysuria or hematuria. Digital rectal exam reveals a symmetrically enlarged, smooth prostate. PSA is mildly elevated but stable compared with prior results. Transrectal ultrasound estimates prostate volume at 45 g. You conclude his diagnosis is benign prostatic hypertrophy with moderate to severe symptoms and an enlarged prostate. His medical history includes hypertension and hyperlipidemia, both well controlled. Current medications include amlodipine and atorvastatin. He reports no history of orthostatic hypotension. Question Which pharmacologic management plan is most appropriate at this time?