Differential Diagnosis of Urinary Symptoms and Pelvic Pain
The differential diagnosis for urinary symptoms and pelvic pain is broad and can be categorized into several groups. Here's a breakdown of potential diagnoses:
Single Most Likely Diagnosis
- Urinary Tract Infection (UTI): This is often the most common cause of urinary symptoms such as dysuria, frequency, and urgency, especially in women. The presence of pelvic pain can also be associated with upper urinary tract infections like pyelonephritis.
Other Likely Diagnoses
- Overactive Bladder: Characterized by urgency, frequency, and nocturia, often without a clear infectious cause.
- Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain, with symptoms worsening as the bladder fills.
- Kidney Stones: Can cause severe pelvic and flank pain, along with urinary symptoms if a stone is obstructing the urinary tract.
- Prostatitis (in men): Inflammation of the prostate gland, which can cause pelvic pain, urinary frequency, and difficulty urinating.
- Endometriosis (in women): A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pelvic pain and sometimes urinary symptoms if the endometrial implants involve the urinary tract.
Do Not Miss Diagnoses
- Appendicitis: Although primarily causing abdominal pain, appendicitis can sometimes present with pelvic pain and urinary symptoms if the appendix is located near the urinary tract.
- Ectopic Pregnancy (in women): A pregnancy in which a fertilized egg implants outside the uterus, often causing severe pelvic pain and potentially life-threatening if ruptured.
- Testicular Torsion (in men): A medical emergency where the spermatic cord becomes twisted, cutting off the blood supply to the testicle, presenting with acute testicular pain that may radiate to the pelvis.
- Ovarian Torsion (in women): Similar to testicular torsion, this is a gynecologic emergency where the ovary twists around its ligaments, cutting off blood supply.
Rare Diagnoses
- Bladder Cancer: Can cause pelvic pain and urinary symptoms such as hematuria (blood in the urine), but is less common than other causes.
- Schistosomiasis: A parasitic infection that can involve the urinary tract, causing symptoms like hematuria and pelvic pain, more common in specific geographic areas.
- Malacoplakia: A rare inflammatory condition that can affect the urinary tract, causing symptoms similar to a UTI, along with pelvic pain.
- Genitourinary tuberculosis: A form of tuberculosis that affects the genital and urinary systems, which can cause a variety of symptoms including pelvic pain and urinary symptoms.