A patient examined has a tender and boggy prostate on DRE. What is the most likely diagnosis?

A tender and boggy prostate found during a digital rectal examination (DRE) is highly indicative of acute prostatitis. This condition is typically characterized by symptoms such as pelvic pain, fever, urinary difficulties, and sometimes systemic signs of infection. The tenderness of the prostate indicates inflammation and potential infection, which is a hallmark of acute prostatitis. The boggy consistency suggests edema and inflammation, distinct from other conditions like benign prostatic hyperplasia, prostate cancer, or chronic prostatitis, where the prostate may not exhibit such acute tenderness or bogginess.

Benign prostatic hyperplasia typically presents with urinary obstruction symptoms but does not generally cause a tender or enlarged prostate to the touch. Chronic prostatitis may cause some discomfort, but it is not often characterized by acute tenderness and is usually associated with more chronic symptoms. Prostate cancer often presents with a hard, nodular prostate rather than a boggy tender one. Thus, the clinical findings point most specifically to acute prostatitis as the most likely diagnosis.