Did I experience long-term complications from an undiagnosed Urinary Tract Infection (UTI) years ago, resulting in dyspareunia (pain after sex), intermittent lower abdominal swelling, and increased urinary frequency?

Differential Diagnosis

The patient's symptoms of pain after sex, lower abdomen swelling, and frequent urination suggest a possible underlying condition related to the urinary or reproductive system. Here's a differential diagnosis organized into categories:

• Single most likely diagnosis
  • Interstitial Cystitis (IC): This condition is characterized by chronic pain in the bladder and pelvic region, often accompanied by frequent urination. The patient's history of undiagnosed UTI and current symptoms align with IC, making it a likely diagnosis.
• Other Likely diagnoses
  • Recurrent Urinary Tract Infections (UTIs): The patient's history of undiagnosed UTI and current symptoms of frequent urination suggest a possible recurrence of UTIs.
  • Endometriosis: This condition can cause pelvic pain, swelling, and frequent urination, especially during or after sex.
  • Pelvic Inflammatory Disease (PID): PID can cause chronic pelvic pain, swelling, and frequent urination, especially if left untreated or undertreated.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Ovarian Cancer: Although less likely, ovarian cancer can cause pelvic pain, swelling, and frequent urination. It's essential to rule out this possibility due to its severe consequences if left undiagnosed.
  • Tuberculosis (TB) of the Urinary Tract: TB can cause chronic pelvic pain, swelling, and frequent urination. Although rare, it's crucial to consider this diagnosis due to its potential severity and need for specific treatment.
• Rare diagnoses
  • Bladder Cancer: This condition can cause frequent urination, pelvic pain, and swelling, although it's less likely in this patient's scenario.
  • Ectopic Pregnancy (in women of childbearing age): Although rare, an ectopic pregnancy can cause pelvic pain, swelling, and frequent urination, especially if the patient is sexually active and not using contraception.
  • Malacoplakia: This rare condition can cause chronic pelvic pain, swelling, and frequent urination, often associated with UTIs or other infections.