Differential Diagnosis for Young Male with Burning Urination and Blood at the End of Urination

Single Most Likely Diagnosis

• Urinary Tract Infection (UTI): This is the most common cause of dysuria (burning urination) and hematuria (blood in urine) in young males. The presence of blood, especially at the end of urination, suggests a lower urinary tract infection, such as cystitis or urethritis.

Other Likely Diagnoses

• Urethritis: Inflammation of the urethra, often due to sexually transmitted infections (STIs) like gonorrhea or chlamydia, can cause dysuria and hematuria.
• Prostatitis: Inflammation of the prostate gland can cause burning urination, pain, and sometimes blood in the urine.
• Kidney Stones: While more common in older adults, kidney stones can occur in young males and cause severe pain, dysuria, and hematuria.

Do Not Miss Diagnoses

• Testicular Cancer: Although rare, testicular cancer can cause hematuria and should be considered, especially if there are other symptoms like testicular masses or pain.
• Trauma: Traumatic injury to the urinary tract can cause hematuria and should be considered, especially if there is a history of recent trauma.
• STIs: Certain STIs, like gonorrhea or chlamydia, can cause severe complications if left untreated, making prompt diagnosis and treatment crucial.

Rare Diagnoses

• Bladder Cancer: Although extremely rare in young males, bladder cancer can cause hematuria and should be considered if other symptoms like weight loss or persistent pain are present.
• Sickle Cell Disease: In individuals with sickle cell disease, sickling of red blood cells can cause hematuria due to renal infarction or papillary necrosis.
• Goodpasture Syndrome: A rare autoimmune disease that can cause glomerulonephritis and hematuria, often accompanied by pulmonary symptoms.