A 68-Year-Old Man Comes to the Office Due to a Weak

A 68-year-old man comes to the office due to a weak urinary stream, hesitancy, and straining on micturition.  These symptoms have been present for the past 2 years but have gradually become more severe and are beginning to affect his quality of life.  The patient recently started noticing continuous urine leakage, nocturia, frequent urination, and urgency.  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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