Differential Diagnosis
The patient's symptoms suggest a complex interplay of urinary, reproductive, and musculoskeletal systems. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Chronic Pelvic Pain Syndrome (CPPS): The patient's history of recurrent lower abdominal pain, frequent urination, and pain after deep penetration suggests CPPS. The condition is often associated with urinary symptoms, and the pain can be exacerbated by physical activity.
- Other Likely diagnoses
- Interstitial Cystitis (IC): The patient's symptoms of frequent urination, pain after sex, and slower urination are consistent with IC. The condition is characterized by chronic inflammation of the bladder, leading to pain and urinary frequency.
- Endometriosis: The patient's history of pain after sex, lower abdominal pain, and bloating suggests endometriosis. The condition is characterized by the growth of endometrial tissue outside the uterus, leading to inflammation and pain.
- Pelvic Floor Dysfunction: The patient's symptoms of slower urination, pain after sex, and lower back pain suggest pelvic floor dysfunction. The condition is characterized by weakness or tightness of the pelvic floor muscles, leading to urinary and reproductive symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ovarian Torsion: Although less likely, ovarian torsion is a life-threatening condition that requires immediate attention. The patient's history of lower abdominal pain and bloating warrants consideration of this diagnosis.
- Kidney Stones: The patient's symptoms of frequent urination, pain, and slower urination could be indicative of kidney stones. If left untreated, kidney stones can lead to severe complications, including kidney damage.
- Deep Vein Thrombosis (DVT): The patient's history of right leg swelling and pain warrants consideration of DVT. The condition is a life-threatening emergency that requires immediate attention.
- Rare diagnoses
- Adenomyosis: The patient's symptoms of pain after sex, lower abdominal pain, and bloating could be indicative of adenomyosis. The condition is characterized by the growth of endometrial tissue into the uterine wall, leading to inflammation and pain.
- Tarlov Cysts: The patient's symptoms of lower back pain, leg swelling, and pain after sex could be indicative of Tarlov cysts. The condition is characterized by the growth of cysts in the spinal cord, leading to nerve compression and pain.