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Amy Krambeck, MD, Professor of Urology and Chief of Endourology and Stone Disease at Northwestern Medicine, presents this week`s interesting case. Case Information: 73 year old gentleman who has been struggling with lower urinary tract symptoms for many years his symptoms consist of nocturnia four to five times per night getting up every hour almost, daytime frequency every half hour to an hour and a high postcode residual of 400 cc's. His ipss score was 25 and his Michigan incontinence score was eight. The patient has been trying multiple medications for the last 10 years. The patient's biggest fear is that he would be diagnosed with prostate cancer and be unable to undergo a radical prostatectomy should he have any type of surgical intervention for his BPH symptoms so he had avoided any type of surgery.