Urethral Stricture: The Daily PANCE Blueprint
A 55-year-old male presents to the clinic with a 6-month history of worsening urinary symptoms. He reports a weak urinary stream, straining to void, a sensation of incomplete bladder emptying, and urinary hesitancy. He denies any fever, chills, or dysuria. His past medical history is significant for recurrent episodes of urethritis in his 20s and 30s, treated with various antibiotics. He also had a straddle injury to his perineum when he was a teenager after falling off a bicycle, for which he did not seek medical attention. On physical examination, his bladder is not palpable. A digital rectal exam reveals a normal-sized prostate without nodules or tenderness. Urinalysis is unremarkable. Which of the following is the most appropriate next step in the evaluation of this patient?
A. Initiate trial of alpha-blocker therapy
B. Urine culture and sensitivity
C. Retrograde urethrogram
D. Serum prostate-specific antigen (PSA) level
E. Transrectal ultrasound of the prostate
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Genitourinary ⇒ Urethral disorders ⇒ Urethral Stricture