Mr. Jerrell is 70 years old and notices difficulty getting started when he attempts to urinate. This is likely a sign of:

Difficulty getting started when attempting to urinate is commonly associated with prostatic hypertrophy, also known as benign prostatic hyperplasia (BPH). This condition is characterized by an enlargement of the prostate gland, which can compress the urethra and impede the flow of urine. As men age, especially those over the age of 50, the likelihood of experiencing BPH increases. Symptoms often include a weak urine stream, difficulty starting and stopping urination, and a sense of incomplete bladder emptying.

While prostatic cancer is a serious condition that can also affect urinary function, the symptom described (difficulty starting urination) more specifically aligns with the benign nature of prostatic hypertrophy. Moreover, urinary tract infections typically present with urgency and burning during urination rather than difficulty initiating urination, and kidney stones often cause pain and may lead to changes in urination patterns but do not typically present solely with difficulty starting urination. Thus, prostatic hypertrophy is the most likely explanation for Mr. Jerrell's symptoms.