A 52-year-old man is evaluated for a 3-month history of perineal and suprapubic pain. He has experienced urinary frequency and dysuria for 4 to 6 weeks. The patient reports fatigue, insomnia, and low mood for the past 6 months. He has hypertension. Current medications are hydrochlorothiazide and acetaminophen as needed for pain.
On physical examination, temperature is normal, blood pressure is 138/80 mm Hg, and pulse rate is 78/min. BMI is 29. Abdominal examination is normal with mild suprapubic tenderness. The prostate is not enlarged; it is mildly tender without nodularity. Testicular examination is normal.
On laboratory study, urinalysis is normal, and urine culture is negative. Prostate-specific antigen level is 0.8 ng/mL (0.8 µg/L).
Which of the following is the most appropriate treatment for this patient?
A) Levofloxacin
B) Naproxen
C) Oxybutynin
D) Saw palmetto
E) Terazosin
See first comment for answer & explanation.
On physical examination, temperature is normal, blood pressure is 138/80 mm Hg, and pulse rate is 78/min. BMI is 29. Abdominal examination is normal with mild suprapubic tenderness. The prostate is not enlarged; it is mildly tender without nodularity. Testicular examination is normal.
On laboratory study, urinalysis is normal, and urine culture is negative. Prostate-specific antigen level is 0.8 ng/mL (0.8 µg/L).
Which of the following is the most appropriate treatment for this patient?
A) Levofloxacin
B) Naproxen
C) Oxybutynin
D) Saw palmetto
E) Terazosin
See first comment for answer & explanation.
