A 58-Year-Old Man Comes to the Office Due to Urinary

A 58-year-old man comes to the office due to urinary symptoms.  Over the past year, he has had difficulty initiating urination and a weakened urine stream.  He also has frequent nocturnal voiding.  The patient has not passed any visible blood clots and has had no dysuria, fever, recent illnesses, or urinary trauma.  He has no other medical conditions and takes no medications.  Vital signs are within normal limits. Rectal examination reveals a smooth, enlarged prostate with no tenderness to palpation.  Prostate-specific antigen is within the normal range.  Urinalysis reveals 20-30 red blood cells per high power field and no urinary casts.  Cystoscopy is performed and shows increased bladder wall trabeculations with normal appearing mucosa.  Which of the following is the most likely cause of this patient's hematuria?

A) Acquired bleeding disorder
B) Friable prostatic blood vessels
C) Glomerulonephritis
D) Interstitial cystitis
E) Transitional cell carcinoma of bladder

Correct Answer:

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