Approach to dysuria Quiz: Ace Your Exams

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A 22-year-old man presents to the clinic with a 3-day history of dysuria and yellow penile discharge. He denies fever, back pain, and gastrointestinal symptoms. He states that he had unprotected sex with a new partner approximately three weeks ago. Vitals are within normal limits. Physical examination is unremarkable except for a mucopurulent discharge seen at the urethral meatus. Which of the following is the most appropriate next step to confirm the diagnosis?

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Nucleic acid amplification testing (NAAT) of first-catch urine

Serum prostate-specific antigen (PSA) testing

Cystoscopy

Intravenous pyelogram

Urinalysis and urine culture