Differential Diagnosis for Recurring Dysuria and Enlarged Prostate
- Single most likely diagnosis
- Chronic Prostatitis: This condition is characterized by recurring episodes of dysuria and pelvic pain, which are exacerbated by sexual activity or urination. The presence of an enlarged prostate with areas of tenderness and fluctuance on rectal examination supports this diagnosis. The recurrence of symptoms after antibiotic therapy suggests a chronic infection that is not fully eradicated by short-term treatment.
- Other Likely diagnoses
- Prostate Abscess: The presence of fluctuance on rectal examination suggests a possible abscess, which can cause recurring symptoms of dysuria and pelvic pain. Antibiotic therapy may not fully penetrate the abscess, leading to recurrence of symptoms after treatment is stopped.
- Benign Prostatic Hyperplasia (BPH): While BPH can cause urinary symptoms such as dysuria, it is less likely to cause recurring episodes of infection. However, BPH can increase the risk of urinary tract infections, which may contribute to the patient's symptoms.
- Do Not Miss diagnoses
- Prostate Cancer: Although less likely, prostate cancer can cause urinary symptoms and an enlarged prostate. It is essential to rule out this diagnosis, as it requires prompt treatment.
- Septic Prostatitis: This is a life-threatening condition that requires immediate medical attention. While less likely, it is crucial to consider this diagnosis, especially if the patient presents with systemic symptoms such as fever, chills, or sepsis.
- Rare diagnoses
- Granulomatous Prostatitis: This is a rare condition characterized by inflammation of the prostate gland, often caused by an autoimmune response or infection. It can cause urinary symptoms and an enlarged prostate, but it is less likely than other diagnoses.
- Tuberculous Prostatitis: This is a rare condition caused by tuberculosis infection of the prostate gland. It can cause urinary symptoms and an enlarged prostate, but it is relatively rare in developed countries.