A 46-Year-Old Man Comes to the Office Due to Dysuria

question 350

Multiple Choice

A 46-year-old man comes to the office due to dysuria and a dull, aching pain in the penis and perineal region.  The symptoms began 6 months ago and prompted the patient to visit an urgent care center twice.  Both times, he received a short course of antibiotics, which improved symptoms temporarily, but they returned within days.  The patient has also had pain during ejaculation but no urethral discharge, back pain, abdominal pain, weakness, or incomplete voiding.  He is married and monogamous with his wife and has 2 children.  He does not use tobacco or illicit drugs but occasionally drinks 1 or 2 beers on weekends.  He has no medication allergies and no family history of cancer.  Temperature is 37.1 C (98.8 F) , blood pressure is 126/84 mm Hg, pulse is 72/min, and respirations are 14/min.  Physical examination shows no abdominal or costovertebral angle tenderness.  Digital rectal examination reveals a mildly tender prostate that is symmetric and not enlarged.  The external genitalia are normal in size and appearance and are nontender to palpation. Urine microscopy after prostate massage reveals 30 leukocytes/hpf, and subsequent culture is negative.  What is the most likely diagnosis?

• A)Acute prostatitis
• B)Chronic bacterial prostatitis
• C)Chronic prostatitis/chronic pelvic pain syndrome
• D)Interstitial cystitis
• E)Overactive bladder

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Definitions:

Amortized

The process of gradually paying off a debt over time in regular installments of interest and principal sufficient to repay the loan fully by its maturity date.

Preferred Stock

A type of stock that typically pays fixed dividends and has priority over common stock in dividend payments and asset liquidation.

Perpetuity

A type of financial annuity that generates an infinite series of equal payments over an indefinable period of time.

Dividends

Cash payouts made by a corporation to its equity holders, usually stemming from the corporate profits.