Differential Diagnosis for a 33-year-old patient with a constant sensation of urge to urinate felt in the tip of the penis

• Single most likely diagnosis
  • Urethritis: This condition, which is an inflammation of the urethra, can cause a frequent and urgent need to urinate, along with discomfort or pain, especially at the tip of the penis. The symptoms can be constant and are often exacerbated by sexual activity or urination.
• Other Likely diagnoses
  • Prostatitis: Inflammation of the prostate gland can lead to urinary urgency, frequency, and pain in the genital area, including the tip of the penis. The symptoms can vary but often include discomfort during urination.
  • Urinary Tract Infection (UTI): While more common in women, men can also experience UTIs, which can cause a strong, persistent urge to urinate, burning sensation while urinating, and sometimes pain or discomfort in the genital area.
  • Overactive Bladder: This condition leads to a frequent and urgent need to urinate. While it's more about the bladder's muscle overactivity, it can cause discomfort and a sensation of needing to urinate, potentially felt in the tip of the penis due to referred pain or associated conditions.
• Do Not Miss diagnoses
  • Testicular Cancer: Although rare and less directly related to the symptoms described, testicular cancer can sometimes present with a sensation of heaviness or discomfort in the testicles, which might be confused with or accompanied by urinary symptoms. It's crucial to examine for testicular masses.
  • STDs (Sexually Transmitted Diseases): Certain STDs like gonorrhea and chlamydia can cause urethritis, leading to symptoms similar to those described. Missing these diagnoses can lead to complications like infertility and increased risk of other infections.
• Rare diagnoses
  • Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can mimic those of a UTI but without the presence of an infection. It's less common in men and might present with a variety of urinary symptoms.
  • Pudendal Neuralgia: This is a condition characterized by chronic pain in the distribution area of the pudendal nerve, which can include the penis. While it doesn't directly cause urinary urgency, the pain can be mistaken for or accompany urinary symptoms, making it a rare but possible consideration.