A 65-year-old man presents with painless hematuria, IVU is normal, prostate is mildly enlarged with mild frequency. What is the most appropriate next step?

The key is B. Flexible cystoscopy. [Painless hematuria in an elderly (here 65 years old man) indicates carcinoma bladder for which flexible cystoscopy is done. Here BEP is not advanced to cause hemorrhage. There is mild enlargement of prostate and mild symptoms of prostatism and hemorrhage is unlikely at this initial stage of BEP which makes Bladder cancer as the likely cause of painless hematuria. It is also less likely to be prostate cancer as symptoms of prostatism are mild (indicates disease is not advanced). Moreover bleeding in cancer prostate is less common].