Differential Diagnosis for a 26-year-old Male with Urinary Symptoms
Single Most Likely Diagnosis
- Prostatitis: The patient's symptoms of suprapubic pain, sharp tip penile pain, frequency, urgency, dysuria, and the feeling of not emptying the bladder are classic for prostatitis, especially given the recent history of prolonged sitting, which could irritate the prostate.
Other Likely Diagnoses
- Urinary Tract Infection (UTI): Symptoms such as frequency, urgency, dysuria, and suprapubic pain could also suggest a UTI. The absence of discharge or swelling does not rule out a UTI, especially if it's an early infection.
- Interstitial Cystitis: This condition could explain the pain and urgency, especially if the patient experiences pain in the bladder and pelvic region. However, it's less common in young males.
- Urethral Stricture: The feeling of not emptying the bladder and the sharp penile pain could be indicative of a urethral stricture, although this would typically be associated with a history of trauma or infection.
Do Not Miss Diagnoses
- Testicular Torsion: Although the patient denies swelling or lesions, testicular torsion can present with severe pain and should always be considered in cases of acute scrotal or penile pain. It's a medical emergency.
- Epididymitis: Similar to testicular torsion, epididymitis can present with pain and should be considered, especially if there's any possibility of sexually transmitted infection or recent urinary tract instrumentation.
- Kidney Stones: While the patient's symptoms are more suggestive of lower urinary tract issues, kidney stones can cause severe pain and should be considered, especially if there's hematuria or if the pain radiates to the back.
Rare Diagnoses
- Reiter's Syndrome (Reactive Arthritis): This condition can follow a bacterial infection and is characterized by a combination of arthritis, urethritis, and conjunctivitis. It's less common but could explain some of the patient's symptoms if there's an associated infection.
- Bladder Cancer: Although extremely rare in a 26-year-old male, any persistent or unexplained urinary symptoms should prompt consideration of bladder cancer, especially if there's hematuria.