A 60 years old male presents with hematuria at onset of micturition, cause is:
**Core Concept**
Benign Prostatic Hyperplasia (BPH) is a common condition in aging men characterized by the enlargement of the prostate gland, leading to urinary symptoms such as hematuria, urinary frequency, and obstructive voiding.
**Why the Correct Answer is Right**
The correct answer is related to the pathophysiology of BPH. As the prostate gland enlarges, it can compress the urethra and cause urinary obstruction. This compression can lead to hematuria at the onset of micturition due to the sudden increase in pressure on the bladder neck and urethra. The histopathological changes in BPH involve an increase in the number of stromal and glandular elements, leading to an overall increase in prostate size.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not accurately describe the typical presentation of BPH. While BPH can cause obstructive symptoms, hematuria at the onset of micturition is more characteristic of other conditions such as bladder neck contracture or urethral stricture.
* **Option B:** This option is incorrect because it refers to a condition that is not typically associated with hematuria at the onset of micturition. Prostatitis can cause urinary symptoms such as dysuria and urinary frequency, but hematuria is not a typical presenting symptom.
* **Option C:** This option is incorrect because it refers to a condition that is not typically associated with BPH. Urethral stricture can cause obstructive urinary symptoms, but it is not a common cause of BPH.
**Clinical Pearl / High-Yield Fact**
A classic exam trap is to remember that BPH typically presents with obstructive urinary symptoms such as urinary frequency, nocturia, and weak stream, rather than hematuria. However, hematuria can occur if there is associated bladder neck contracture or urethral stricture.
**Correct Answer:** C.