A 65-year-old male presents with constipation, urinary symptoms, and lower back pain. What could be the potential causes, and what are the next steps?
The combination of constipation, urinary symptoms, and lower back pain in a man of this age raises the possibility of prostate enlargement or prostate cancer pressing on the rectum and bladder. Other potential causes include spinal stenosis or cauda equina syndrome. He should have a digital rectal examination, prostate-specific antigen (PSA) testing, and potentially an MRI or CT scan of the lower back and pelvis. Referral to a urologist or neurologist may also be warranted depending on the findings.