An 18-year-old male presents with painful urination and yellow-green urethral discharge without abdominal pain. The most likely diagnosis is which of the following?

An 18-year-old male presents with painful urination and yellow-green urethral discharge without abdominal pain. The most likely diagnosis is which of the following?

• A. Varicocele
• B. Testicular torsion
• C. Epididymitis
• D. Gynecomastia

Answer: (C)

Painful urination with purulent urethral discharge in a sexually active young man points to an infectious process of the lower urinary tract that often involves the genital tract as well. Among the given conditions, the one that best fits a scenario where an infection can ascend from the urethra to the epididymis is epididymitis. This condition commonly occurs in sexually active males and can be linked to urethral infections such as gonorrhea or other sexually transmitted pathogens. The presence of urethral discharge signals an infectious process, and while the primary symptom of epididymitis is scrotal or testicular pain and tenderness, it can be part of the same infectious spectrum that starts with urethritis and then involves the epididymis. The other options describe conditions with different dominant features: varicocele is typically a painless scrotal lump, testicular torsion presents with acute severe testicular pain, and gynecomastia involves breast tissue development rather than urogenital infection.

Painful urination with purulent urethral discharge in a sexually active young man points to an infectious process of the lower urinary tract that often involves the genital tract as well. Among the given conditions, the one that best fits a scenario where an infection can ascend from the urethra to the epididymis is epididymitis. This condition commonly occurs in sexually active males and can be linked to urethral infections such as gonorrhea or other sexually transmitted pathogens. The presence of urethral discharge signals an infectious process, and while the primary symptom of epididymitis is scrotal or testicular pain and tenderness, it can be part of the same infectious spectrum that starts with urethritis and then involves the epididymis. The other options describe conditions with different dominant features: varicocele is typically a painless scrotal lump, testicular torsion presents with acute severe testicular pain, and gynecomastia involves breast tissue development rather than urogenital infection.