Differential Diagnosis for Hematuria and Penile Irritation
- Single most likely diagnosis
- Urethritis: This is the most likely diagnosis given the patient's symptoms of painful urination, hematuria, and penile irritation after receiving oral sex. The symptoms suggest an inflammatory process, which could be caused by a bacterial or viral infection.
- Other Likely diagnoses
- Trauma to the urethra: The patient's recent history of receiving oral sex could have caused minor trauma to the urethra, leading to hematuria and irritation.
- Prostatitis: Although less common, prostatitis could cause painful urination, hematuria, and penile irritation, especially if the patient has a history of prostate issues.
- Urinary tract infection (UTI): A UTI could cause similar symptoms, including painful urination, hematuria, and irritation, although it is less common in men than in women.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Testicular torsion: Although the patient's symptoms do not directly suggest testicular torsion, it is a medical emergency that requires prompt attention. If missed, it could lead to testicular necrosis and long-term infertility.
- Epididymitis: This condition can cause severe pain, swelling, and inflammation of the epididymis, and if left untreated, can lead to complications such as abscess formation or infertility.
- Urethral stricture: A urethral stricture could cause obstructive symptoms, including painful urination and hematuria. If left untreated, it could lead to long-term complications such as urinary retention or kidney damage.
- Rare diagnoses
- Urethral carcinoma: Although extremely rare, urethral carcinoma could cause hematuria, painful urination, and penile irritation. It is essential to consider this diagnosis, especially if the patient has a history of smoking or exposure to carcinogens.
- Penile cancer: Similarly, penile cancer is a rare condition that could cause irritation, pain, and bleeding. It is essential to consider this diagnosis, especially if the patient has a history of poor genital hygiene or exposure to human papillomavirus (HPV).