**Core Concept**
Terminal hematuria refers to the presence of blood at the end of the urinary stream, often indicative of a lower urinary tract issue, such as a urethral stricture or an enlarged prostate gland.

**Why the Correct Answer is Right**
Terminal hematuria typically occurs when there is an obstruction or narrowing of the urethra, causing the blood to be squeezed out at the end of urination. This can be due to conditions like urethral stricture, benign prostatic hyperplasia (BPH), or even a urethral stone. The blood is often seen at the end of the urinary stream due to the increased pressure required to overcome the obstruction.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because terminal hematuria is not typically associated with conditions affecting the upper urinary tract, such as pyelonephritis or kidney stones, which would cause hematuria throughout the stream rather than at the end.
* **Option B:** This option is incorrect because hematuria can occur in the absence of infection, such as in cases of BPH or urethral stricture.
* **Option C:** This option is incorrect because hematuria is not typically associated with conditions affecting the bladder, such as interstitial cystitis, which would cause symptoms like frequency and urgency rather than terminal hematuria.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that terminal hematuria often requires a digital rectal examination (DRE) to assess for an enlarged prostate or urethral stricture, as these conditions can be palpable on examination.

**Correct Answer: D. Urethral stricture**