A 24-year-old graduate student comes to your clinic, complaining of burning during urination and increased urinary frequency. He has had a low-grade fever (100.5 degrees) and does not feel very well. He is very worried about sexually transmitted diseases because he had a drunken encounter 2 weeks ago and did not use a condom. He has had no recent weight loss, weight gain, or night sweats. His past medical history includes knee surgery in high school and genital warts in college. He does not smoke but drinks six beers every Friday and Saturday night. He denies using any IV drugs but has tried marijuana in the past. His father has high cholesterol but his mother is healthy. On examination he appears tired. His temperature is 99.5 degrees and his blood pressure is 110/70. His abdominal examination is normal. Visualization of the anus shows no masses, inflammation, or fissures. Digital rectal examination reveals a warm, boggy, tender prostate. No discrete masses are felt and there is no blood on the glove. The scrotum and penis appear normal. Urinalysis shows moderate amounts of white blood cells and bacteria. What disorder of the anus, prostate, or rectum best describes this situation?

Question

Quizplus · Accepted Answer

Prostatitis generally causes increased frequency of urination, pain with urination, and lower back pain. On digital rectal examination a warm, tender, boggy prostate will be palpated. In young men the etiology is often a sexually transmitted disease such as chlamydia or gonorrhea. This man's substance abuse problem should also be discussed with him, and you should consider further questions and screening for HIV.

A 24-Year-Old Graduate Student Comes to Your Clinic, Complaining of Burning