Problem
A 52-year-old African American male lives at home with his wife. He reports frequent urination that burns and is painful, also pain with defecation or with the act of sexual intercourse. He states that since last night he has had pain with urination, and also complains of dribbling, hesitancy, a decreased stream, and painful ejaculation. Denies urethral discharge, urethral meatal itching, hematuria, or incontinence. Rates pain as a 9 out of 10 on a scale of 0-10. Has never been diagnosed with an STI. His normal bowel pattern is daily with formed, brown stool. Denies any recent history of blood or changes in his bowel, and denies laxative use.
Quit smoking for 10 years. However, he did smoke 1 pack per day for 20 years. Had the first colonoscopy at age 50, and states results were normal.
What is the pathophysiology of the disease?